Archives of Sexual Behavior

, Volume 48, Issue 3, pp 763–779 | Cite as

Development and Validation of the Power Imbalance in Couples Scale

  • Torsten B. Neilands
  • Shari L. Dworkin
  • Deepalika Chakravarty
  • Chadwick K. Campbell
  • Patrick A. Wilson
  • Anu Manchikanti Gomez
  • Kirk K. Grisham
  • Colleen C. HoffEmail author
Original Paper


Few researchers have quantitatively explored the relationship power-HIV risk nexus in same-sex male couples. We developed and validated the Power Imbalance in Couples Scale (PICS) to measure relationship power among men in same-sex, committed relationships and its association with sexual risk behaviors. We recruited three independent and diverse samples of male couples in the greater San Francisco and New York City metropolitan areas and conducted qualitative interviews (N1 = 96) to inform item development, followed by two quantitative surveys (N2 = 341; N3 = 434) to assess the construct, predictive, convergent, and discriminant validity of the PICS. Exploratory factor analysis of the first survey’s data yielded four factors—overtly controlling partner, supportive partner, conflict avoidant actor, and overtly controlling actor—that accounted for more than 50% of the shared variance among the PICS items. Confirmatory factor analysis (CFA) of the second survey’s data supported these four factors: χ2(1823) = 2493.40, p < .001; CFI = .96, RMSEA = .03 and WRMR = 1.33. Strong interfactor correlations suggested the presence of a higher-order general perception of power imbalance factor; a higher-order factor CFA model was comparable in fit to the correlated lower-order factors’ CFA: χ2(2) = 2.00, p = .37. Internal reliability of the PICS scale was strong: α = .94. Men perceiving greater power imbalances in their relationships had higher odds of engaging in condomless anal intercourse with outside partners of discordant or unknown HIV status (OR 1.27; 95% CI 1.01–1.60; p = .04). The PICS is an important contribution to measuring relationship power imbalance and its sequelae among male couples; it is applicable to research on relationships, sexuality, couples, and HIV prevention.


Gay male couples Relationship power Sexual risk behavior HIV Sexual orientation 


  1. Amaro, H. (1995). Love, sex, and power: Considering women’s realities in HIV prevention. American Psychologist, 50, 437–447.CrossRefGoogle Scholar
  2. Bentler, P. M., & Bonnett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606.CrossRefGoogle Scholar
  3. Blair-Loy, M., Hochschild, A., Pugh, A., Williams, J. C., & Hartman, H. (2015). Stability and transformation in gender, work, and family: Insights from the second shift for the next quarter century. Community, Work, & Family, 18, 435–454.CrossRefGoogle Scholar
  4. Blanc, A. K. (2001). The effect of power in sexual relationships on sexual and reproductive health: An examination of the evidence. Studies in Family Planning, 32, 189–213.CrossRefGoogle Scholar
  5. Bollen, K. A., & Long, J. S. (1993). Introduction. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 1–9). Newbury Park, CA: Sage Publications.Google Scholar
  6. Bosson, J. K., Vandello, J. A., Burnaford, R. M., Weaver, J. R., & Wasti, S. A. (2009). Precarious manhood and displays of physical aggression. Personality and Social Psychology Bulletin, 35, 623–634.CrossRefGoogle Scholar
  7. Bowleg, L., Teti, M., Massie, J. S., Patel, A., Malebranche, D. J., & Tschann, J. M. (2011). ‘What does it take to be a man? What is a real man?’: Ideologies of masculinity and HIV sexual risk among Black heterosexual men. Culture, Health, & Sexuality, 13, 545–559.CrossRefGoogle Scholar
  8. Browne, M. W., & Cudek, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage Publications.Google Scholar
  9. Campbell, C., Manchikanti Gómez, A., Wilson, P. A., Grisham, K., Hoff, C., & Dworkin, S. L. (2016). HIV-risk among age-discrepant same-sex male couples: A qualitative investigation. Culture, Health & Sexuality, 18, 1319–1332.CrossRefGoogle Scholar
  10. Carballo-Diéguez, A., Remien, R. H., Dolezal, C., & Wagner, G. (1997). Unsafe sex in the primary relationships of Puerto Rican men who have sex with men. AIDS and Behavior, 1, 9–17.CrossRefGoogle Scholar
  11. Christensen, A., & Shenk, J. L. (1991). Communication, conflict, and psychological distance in non-distressed, clinic, and divorcing couples. Journal of Consulting Clinical Psychology, 59, 458–463.CrossRefGoogle Scholar
  12. Connell, R. W. (1987). Gender and power. Palo Alto, CA: Stanford University Press.Google Scholar
  13. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
  14. Darbes, L. A., Chakravarty, D., Neilands, T. B., Beougher, S. C., & Hoff, C. C. (2014). Sexual risk for HIV among gay male couples: A longitudinal study of the impact of relationship dynamics. Archives of Sexual Behavior, 43(1), 47–60.CrossRefGoogle Scholar
  15. Derogatis, L. R., & Melisaratos, N. (1983). The brief symptoms inventory: An introductory report. Psychological Medicine, 13, 595–605.CrossRefGoogle Scholar
  16. Devieux, J., Rosenberg, R., Saint-Jean, G., Bryant, V., & Malow, R. (2015). The continuing challenge of reducing HIV risk among Haitian youth: The need for intervention. Journal of the Association of Providers of AIDS Care, 14, 217–233.CrossRefGoogle Scholar
  17. Dunbar, N. E., & Burgoon, J. K. (2005). Perceptions of power and interactional dominance in interpersonal relationships. Journal of Social and Personal Relationships, 22, 207–233.CrossRefGoogle Scholar
  18. Duttweiler, P. D. (1984). The internal control index: A newly developed measure of locus of control. Education and Psychological Measurement, 44, 209–221.CrossRefGoogle Scholar
  19. Dworkin, S. L. (2015). Men at risk: Masculinity, heterosexuality and HIV prevention. New York: NYU Press.Google Scholar
  20. Dworkin, S. L., Sakaras, J. M., Campbell, C., Wilson, P., Grisham, K., Gomez, A., … Hoff, C. (2017). Relationship power among same sex male couples in New York and San Francisco: Laying the groundwork for sexual risk reduction interventions focused on interpersonal power. Journal of Sex Research, 54, 923–925.CrossRefGoogle Scholar
  21. Dworkin, S. L., Treves-Kagan, S., & Lippman, S. A. (2013). Gender-transformative interventions to reduce violence and HIV risks with heterosexually-active men: A global review of the evidence. AIDS and Behavior, 17, 2845–2863.CrossRefGoogle Scholar
  22. Eisler, R. M., & Skidmore, J. R. (1987). Masculine gender role stress: Scale development and component factors in the appraisal of stressful situations. Behavior Modiication, 11, 123–136.CrossRefGoogle Scholar
  23. Emerson, R. M. (1972). Exchange theory, part 1: A psychological basis for social exchange. Sociological Theories, 2, 38–57.Google Scholar
  24. Evans, W. (1996). Computer-supported content analysis: Trends, tools, and techniques. Social Science Computer Review, 14, 269.CrossRefGoogle Scholar
  25. Farrell, A. K., Simpson, J. A., & Rothman, A. J. (2015). The Relationship Power Inventory: Development and validation. Personal Relationships, 22, 1–27.CrossRefGoogle Scholar
  26. Flora, D. B., & Curran, P. J. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9, 466–491.CrossRefGoogle Scholar
  27. Gerbing, D. W., & Hamilton, J. G. (1996). Viability of exploratory factor analysis as a precursor to confirmatory factor analysis. Structural Equation Modeling, 3, 62–72.CrossRefGoogle Scholar
  28. Gomez, A. M., Beougher, S. C., Chakravarty, D., Neilands, T. B., Mandic, C. G., Darbes, L. A., & Hoff, C. C. (2012). Relationship dynamics as predictors of broken agreements about outside sexual partners: Implications for HIV prevention among gay couples. AIDS and Behavior, 16, 1584–1588.CrossRefGoogle Scholar
  29. Goodreau, S. M., Carnegie, N. B., Vittinghoff, E., Lama, J. R., Sanchex, J., Grinsztejn, B., & Buchbinder, S. P. (2012). What drives the US and Peruvian epidemics in men who have sex with men (MSM)? PLoS ONE, 7, e50522.CrossRefGoogle Scholar
  30. Halkitis, P. N., Green, K. A., & Wilton, L. (2004). Masculinity, body image, and sexual behavior in HIV-seropositive gay men: A two-phase formative behavioral investigation using the internet. International Journal of Men’s Health, 3, 27–42.CrossRefGoogle Scholar
  31. Hallman, K. (2004). Socioeconomic disadvantage and unsafe sexual behaviors among young women and men in South Africa. Policy Research Division Working Paper No. 190. Retrieved from
  32. Harry, J. (1982). Decision making and age differences among gay male couples. Journal of Homosexuality, 8, 9–21.CrossRefGoogle Scholar
  33. Harry, J., & DeVall, W. (1978). Age and sexual culture among homosexually oriented males. Archives of Sexual Behavior, 7, 199–209.CrossRefGoogle Scholar
  34. Heavey, C. L., Larson, B., Christensen, A., & Zumtobel, D. C. (1996). The Communication Patterns Questionnaires: The reliability and validity of a constructive communication subscale. Journal of Marriage and the Family, 58, 796–800.CrossRefGoogle Scholar
  35. Henderson, N., & Shefer, T. (2008). Practices of power and abuse in gay male relationships: An exploratory case study of a young, isiXhosa-speaking man in the Western Cape, South Africa. South African Journal of Psychology, 38, 1–20.CrossRefGoogle Scholar
  36. Hoff, C. C., & Beougher, S. C. (2010). Sexual agreements among gay male couples. Archives of Sexual Behavior, 39, 774–787.CrossRefGoogle Scholar
  37. Hoff, C. C., Beougher, S. C., Chakravarty, D., Darbes, L. A., & Neilands, T. B. (2010). Relationship characteristics and motivations behind agreements among gay male couples: Differences by agreement type and couple serostatus. AIDS Care, 22, 827–835.CrossRefGoogle Scholar
  38. Hoff, C. C., Campbell, C. K., Chakravarty, D., & Darbes, L. A. (2016). Relationship-based predictors of sexual risk for HIV among MSM couples: A systematic review of the literature. AIDS and Behavior, 20, 2873–2892.CrossRefGoogle Scholar
  39. Hoff, C. C., Chakravarty, D., Beougher, S. C., Neilands, T. B., & Darbes, L. A. (2012). Relationship characteristics associated with sexual risk behavior among MSM in committed relationships. AIDS Patient care and STDs, 26, 738–745.CrossRefGoogle Scholar
  40. Hoff, C. C., Chakravarty, D., Bircher, A. E., Campbell, C. K., Grisham, K., Neilands, T. B., … Dworkin, S. L. (2015). Attitudes towards PrEP and anticipated condom use among concordant HIV-negative and HIV-discordant male couples. AIDS Patient Care and STDs, 29, 408–417.CrossRefGoogle Scholar
  41. Howard, J. A., Blumstein, P., & Schwartz, P. (1986). Sex, power, and influence tactics in intimate relationships. Journal of Personality and Social Psychology, 51, 102–109.CrossRefGoogle Scholar
  42. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
  43. Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York, NY: Guilford Press.Google Scholar
  44. Kubicek, K., McNeeley, M., & Collins, S. (2015). “Same-sex relationship in a straight world”: Individual and societal influences on power and control in young men’s relationships. Journal of Interpersonal Violence, 30, 83–109.CrossRefGoogle Scholar
  45. Larzelere, R. E., & Huston, T. L. (1980). The Dyadic Trust Scale: Toward understanding interpersonal trust in close relationships. Journal of Marriage and Family, 42, 595–604.CrossRefGoogle Scholar
  46. Lundy, S., & Levanthal, B. (1999). Same-sex domestic violence: Strategies for change. Thousand Oaks, CA: Sage.Google Scholar
  47. McDonald, R. P. (1985). Factor analysis and related methods. Hillsdale, NJ: Lawrence Erlbaum and Associates.Google Scholar
  48. McMahon, J., Volpe, E. M., Klostermann, K., Trabold, N., & Xue, Y. (2015). A systematic review of the psychometric properties of the Sexual Relationship Power scale in HIV/AIDS research. Archives of Sexual Behavior, 44, 267–294.CrossRefGoogle Scholar
  49. Meyer, I. H., Frost, D. M., Narvaez, R., & Dietrich, J. H. (2006). Project Stride methodology and technical notes. Unpublished manuscript.Google Scholar
  50. Mitchell, J. W., Harvey, S. M., Champeau, D., & Seal, D. W. (2012). Relationship factors associated with HIV risk among a sample of gay male couples. AIDS and Behavior, 16, 404–411.CrossRefGoogle Scholar
  51. Mitchell, J. W., & Sophus, A. I. (2017). Perceptions and definitions of power within the context of HIV-negative male couples’ relationships. American Journal of Men’s Health, 11, 801–810.CrossRefGoogle Scholar
  52. Nemoto, T., Operario, D., Soma, T., Boa, D., Vajrabukka, A., & Crisostomo, V. (2003). HIV risk and prevention among Asian/Pacific Islander men who have sex with men: Listen to our stories. AIDS Education and Prevention, 15, 7–20.CrossRefGoogle Scholar
  53. Newcomb, M. E., & Mustanski, B. (2016). Developmental change in the effects of sexual partner and relationship characteristics on sexual risk behavior in young men who have sex with men. AIDS and Behavior, 20, 1284–1294.CrossRefGoogle Scholar
  54. Oreffice, S. (2011). Sexual orientation and household decision making: Same-sex couples’ balance of power and labor supply choices. Labour Economics, 18, 145–158.CrossRefGoogle Scholar
  55. Perry, N. S., Huebner, D. M., Baucom, D. R. W., & Hoff, C. C. (2016). The complex contribution of sociodemographics to decision-making power in gay male couples. Journal of Family Psychology, 30, 977–986.CrossRefGoogle Scholar
  56. Pleck, J. H., Sonenstein, F. L., & Ku, L. C. (1993). Masculinity ideology: Its impact on adolescent males’ heterosexual relationships. Journal of Social Issues, 49, 11–29.CrossRefGoogle Scholar
  57. Pulerwitz, J., Amaro, H., De Jong, W., Gortmaker, S. L., & Rudd, R. (2002). Relationship power, condom use and HIV risk among women in the USA. AIDS Care, 14, 789–800.CrossRefGoogle Scholar
  58. Pulerwitz, J., & Barker, G. (2008). Measuring attitudes toward gender norms among young men in Brazil: Development and psychometric evaluation of the GEM Scale. Men and Masculinities, 10, 322–338.CrossRefGoogle Scholar
  59. Pulerwitz, J., Gortmaker, S. L., & DeJong, W. (2000). Measuring sexual relationship power in HIV/STD research. Sex Roles, 42, 637–660.CrossRefGoogle Scholar
  60. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  61. Rusbult, C. E., Martz, J. M., & Agnew, C. R. (1998). The Investment Model Scale: Measuring commitment level, satisfaction level, quality of alternatives, and investment size. Personal Relationships, 5, 357–391.CrossRefGoogle Scholar
  62. Santana, M. C., Raj, A., Decker, M. R., La Marche, A., & Silverman, J. G. (2006). Masculine gender roles associated with increased sexual risk and intimate partner violence perpetration among young adult men. Journal of Urban Health, 83, 575–585.CrossRefGoogle Scholar
  63. Simpson, J. A., Farrell, A. K., Oriña, M. M., & Rothman, A. J. (2015). Power and social infuence in relationships. In J. A. Simpson & J. F. Dovidio (Eds.), APA handbook of personality and social psychology: Inter-personal relations (pp. 393–420). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  64. Sprecher, S., & Felmlee, D. (1997). The balance of power in romantic heterosexual couples over time from “his” and “her” perspectives. Sex Roles, 37, 361–379.CrossRefGoogle Scholar
  65. Stevens, J. P. (1992). Applied multivariate statistics for the social sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
  66. Stirratt, M., Meyer, I. H., Ouellette, S. C., & Gara, M. A. (2008). Measuring identity multiplicity and intersectionality: Hierarchical class analysis (HICLAS) of sexual, racial and gender identities. Self & Society, 7, 89–111.Google Scholar
  67. Stokes, L., Harvey, M., & Warren, J. C. (2016). Individual, interpersonal, and structural power: Associations with condom use in a sample of young adult Latinos. Health Care for Women International, 37, 216–236.CrossRefGoogle Scholar
  68. Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23, 1153–1162.CrossRefGoogle Scholar
  69. Thebaud, S. (2010). Masculinity, bargaining, and breadwinning: Understanding men’s housework in the cultural context of paid work. Gender and Society, 24, 330–351.CrossRefGoogle Scholar
  70. Vandello, J. A., & Bosson, J. K. (2013). Hard won and easily lost: A review and synthesis of theory and research on precarious manhood. Psychology of Men & Masculinity, 14, 101–113.CrossRefGoogle Scholar
  71. Watkins-Hayes, C. (2015). Intersectionality and the sociology of HIV/AIDS: Past, present and future research directions. Annual Review of Sociology, 40, 431–457.CrossRefGoogle Scholar
  72. Weber, C., & Federico, C. M. (2007). Interpersonal attachment and patterns of ideological belief. Political Psychology, 28, 389–416.CrossRefGoogle Scholar
  73. White, H. (1980). A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrics, 48, 817–838.CrossRefGoogle Scholar
  74. Woods, D., & Fassnacht, C. (2007). Transana v2.23-MU (Version 2.2x). Madison, WI: The Board of Regents of the University of Wisconsin System.Google Scholar
  75. Yu, C. Y. (2002). Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes (Unpublished doctoral dissertation). University of California, Los Angeles, Los Angles, CA.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Torsten B. Neilands
    • 1
  • Shari L. Dworkin
    • 1
    • 3
    • 6
  • Deepalika Chakravarty
    • 1
    • 2
  • Chadwick K. Campbell
    • 1
    • 3
  • Patrick A. Wilson
    • 4
  • Anu Manchikanti Gomez
    • 5
  • Kirk K. Grisham
    • 4
  • Colleen C. Hoff
    • 2
    Email author
  1. 1.Center for AIDS Prevention StudiesUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Center for Research and Education on Gender and SexualitySan Francisco State UniversitySan FranciscoUSA
  3. 3.Department of Social and Behavioral SciencesUniversity of California, San FranciscoSan FranciscoUSA
  4. 4.Department of Sociomedical Sciences, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  5. 5.Sexual Health and Reproductive Equity Program, School of Social WelfareUniversity of California, BerkeleyBerkeleyUSA
  6. 6.School of Nursing and Health StudiesUniversity of WashingtonBothellUSA

Personalised recommendations