A new measurement of an indirect measure of condom use and its relationships with barriers

Abstract

One of the challenges facing researchers in the domain of human immunodeficiency virus prevention is the assessment of condom use in an unbiased self-reported manner. The current study presents the development and preliminary validation of an indirect condom use test (I-CUTE), designed to assess condom use tendencies and to overcome self-report biases. Two samples were included using correlational designs. In sample 1, 88 students from European university completed the I-CUTE with questionnaires of condom use barriers, social desirability, and condom use negotiation self-efficacy. In sample 2, 212 students from sub-Saharan universities completed the I-CUTE with questionnaires of condom use barriers and knowledge. The I-CUTE included 17 pictures of human figures in relation to condom use, where participants had to choose one of the four a-priori given sentences reflecting the figures’ thoughts. This represented a semi-projective, yet standardized test. In sample 1, I-CUTE scores were inversely related to barriers, positively correlated with condom use negotiation self-efficacy and unrelated to social desirability. In sample 2, I-CUTE scores were inversely related to barriers and unrelated to knowledge scores. In a multiple regression, condom use barriers had a unique contribution to explaining variance in I-CUTE scores, beyond the contribution of background variables and knowledge. These results support the preliminary reliability and validity of the I-CUTE tool in a variety of cultures, and reveal its lack of bias by social desirability and the importance of condom use barriers in condom use tendencies.

Effects of a computerized psychological inoculation intervention on condom use tendencies in sub Saharan and Caucasian students: two feasibility trials

“…To calculate the sample size, our primary outcome was the I-CUTE scores. We derived the anticipated mean (and SD) of the I-CUTE from Levy et al (2017) which was conducted on Sub-Saharan students. Assuming 10-15% higher I-CUTE score in the PI group compared to controls after treatment, a statistical significance of p < 0.05 and statistical power of 0.80, the total required sample size was 34-78 (www.stat.ubc.ca).…”

“…Condom use tendencies : This was assessed by the indirect condom use test (I-CUTE; Levy et al., 2017 ). This test was based on the method of the Rosenzweig Picture Frustration Test (RPFT; Rosenzweig, 1978 ).…”

“…This semi-projective tool was developed to reduce self-reported biases. Moreover, this tool was developed in accordance with gender-related issues discussing relationship power, gender inequality and decision making, all relevant to condom use in different cultures (Bauermeister, Hickok, Meadowbrooke, Veinot, & Loveluck, 2014 ; Levy et al., 2017 ; Olley et al., 2011 ; Pulerwitz, Amaro, Jong, Gortmaker, & Rudd, 2002 ). In its development, the I-CUTE had an adequate internal reliability (a Cronbach’s Alpha of 0.74), and its scores correlated significantly with condom use barriers, and did not correlate with social desirability.…”

“…Background information included age, gender, having a partner, having sexual relations with the partner and using a contraceptive. The outcome measures included the condom use barriers scale (St. Lawrence et al., 1999 ), and the I-CUTE for assessing condom use tendencies (Levy et al., 2017 ). In Study 2, the internal reliability of the barriers scale was high (Cronbach’s alpha = .86), as was that of the I-CUTE (Cronbach’s alpha = .84).…”

“…In addition, previous studies assessed condoms via self-report methods, which in such contexts, are heavily biased by social desirability. A newly developed semi-projective tool, the Indirect Condom Use Test (I-CUTE), tries to specifically overcome this issue (Levy, Gidron, & Olley, 2017 ), and was used in the present study.…”