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Development and Psychometric Evaluation of the PrEP Sexual Expectancies (PSEXS) Scale

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Abstract

The goal of this study was to develop and evaluate psychometric properties of the PrEP Sexual Expectancies Scale (PSEXS). The PSEXS represents a range of expectations for how PrEP use will affect one's sexual experience. The scale was developed to understand perceived reinforcements of PrEP use among men who have sex with men (MSM), including sexual risk-taking. The study builds upon Expectancy Theory to develop a measure of sex-related PrEP expectancies with a representative sample of 1155 MSM participants from Ukraine and 408 MSM participants from the U.S. Expectancy items represented two domains: increased sexual risk-taking and enhancement of sexual experience. Confirmatory analyses showed that a two-factor model provided a good fit to the data. The PSEXS scale had a high internal reliability in both samples (Ukraine α = 0.88, U.S. α = 0.83), and the identified factor structure explains a large amount of variance in both samples. Recent studies suggest that expectations of intimacy and better sexual experience can be a significant deciding factor for PrEP uptake. The PSEXS provides researchers with a useful measure for examining MSM’s expectancy beliefs about the impact of PrEP use on their sexual life.

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Funding

Financial support for this study was provided in part by the National Institute of Mental Health (P30MH58107, Dubov), National Institute on Drug Abuse (K24 DA017072, Altice) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR060231, Fraenkel). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

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Authors and Affiliations

  1. Loma Linda University School of Behavioral Health, 11065 Campus Street, Loma Linda, CA, 92350, USA

    Alex Dubov

  2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Massachusetts Hall, Cambridge, MA, 02138, USA

    Adedotun Ogunbajo

  3. Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-2283, USA

    Frederick L. Altice

  4. Section of Rheumatology, Yale University School of Medicine, 300 Cedar Street, TAC Bldg., PO Box 208031, New Haven, CT, 06520-8031, USA

    Liana Fraenkel

  5. Loma Linda University, Griggs Hall, Office 113, 11065 Campus St., Loma Linda, CA, 92350, USA

    Brian Distelberg

Authors
  1. Alex Dubov
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  2. Adedotun Ogunbajo
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  3. Frederick L. Altice
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  4. Liana Fraenkel
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  5. Brian Distelberg
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Correspondence to Alex Dubov.

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Appendices

Appendix

PrEP Sexual Expectancies Scale (PSEXS)

Many people believe that PrEP can influence how they feel and act sexually. We would like to know how you think PrEP affects your sexual feelings and behavior.

Please rate these statements based on your beliefs about PrEP. When using PrEP:

Strongly Disagree

Disagree

Neither Agree nor Disagree

Agree

Strongly Agree

1

2

3

4

5

 

1

2

3

4

5

Factor 1: sexual risk taking

 1. I may be less likely to inquire about my partner’s HIV status before sex

     

 2. I may be less likely to ask for/ discuss/ use condoms

     

Factor 2: enhanced sexual experience

 1. I may be more likely to have more adventurous sex

     

 2. I think my sexual performance will be enhanced

     

 3. I may feel more relaxed during sex

     

 4. I think it will be easier to express my sexual needs or desires

     

 5. I think sex will probably be more loving

     

 6. I may think about sex more often

     

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Dubov, A., Ogunbajo, A., Altice, F.L. et al. Development and Psychometric Evaluation of the PrEP Sexual Expectancies (PSEXS) Scale. AIDS Behav 25, 1192–1198 (2021). https://doi.org/10.1007/s10461-020-03087-7

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  • DOI: https://doi.org/10.1007/s10461-020-03087-7

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