A Systematic Review of the Psychometric Properties of the Sexual Relationship Power Scale in HIV/AIDS Research

Abstract

The Sexual Relationship Power Scale (SRPS) was developed over a decade ago to address the lack of reliable and valid measures of relationship power in social, behavioral and medical research. The SRPS and its two subscales (relationship control [RC], decision-making dominance [DMD]) have been used extensively in the field of HIV prevention and sexual risk behavior. We performed a systematic review of the psychometric properties of the SRPS and subscales as reported in the HIV/AIDS literature from 2000 to 2012. A total of 54 published articles were identified, which reported reliability or construct validity estimates of the scales. Description of the psychometric properties of the SRPS and subscales is reported according to study population, and several cross-population trends were identified. In general, the SRPS and RC subscale exhibited sound psychometric properties across multiple study populations and research settings. By contrast, the DMD subscale had relatively weak psychometric properties, especially when used with specific populations and research settings. Factors that influenced the psychometric properties of the various scales and subscales included the study population, mean age of the sample, number of items retained in the scale, and modifications to the original scales. We conclude with recommendations for (1) the application and use of the SRPS and subscales, (2) reporting of psychometric properties of the scales in the literature, and (3) areas for future research.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Amaro, H. (1995). Love, sex, and power: Considering women’s realities in HIV prevention. American Psychologist, 50, 437–447. doi:10.1037/0003066X.50.6.437.

    Article  PubMed  Google Scholar 

  2. Amaro, H., Larson, M. J., Zhang, A., Acevedo, A., Dai, J., & Marsumoto, A. (2007). Effects of trauma intervention on HIV sexual risk behaviors among women with co-occurring disorders in substance abuse treatment. Journal of Community Psychology, 35, 895–908. doi:10.1002/jcpo.20188.

    Article  Google Scholar 

  3. Beckman, L. J., Harvey, S. M., Thorburn, S., Maher, J. E., & Burns, K. L. (2006). Women’s acceptance of the diaphragm: The role of relationship factors. Journal of Sex Research, 43, 297–306. doi:10.1080/00224490609552329.

    Article  PubMed  Google Scholar 

  4. Bermudez, M. P., Castro, A., Gude, F., & Buela-Casal, G. (2010). Relationship power in the couple and sexual double standard as predictors of the risk of sexual transmission infections and HIV: Multicultural and gender differences. Current HIV Research, 8, 172–178. doi:10.2174/157016210790442669.

    Article  PubMed  Google Scholar 

  5. Blanc, A. K. (2001). The effect of power in sexual relationships on sexual and productive health: An examination of the evidence. Studies in Family Planning, 32, 189–213. doi:10.111/j.1728-4465.2001.00189.X.

    Article  PubMed  Google Scholar 

  6. Bralock, A. R., & Koniak-Griffin, D. (2007). Relationship, power, and other influences on self-protective sexual behaviors of African American female adolescents. Health Care for Women International, 28, 247–267. doi:10.1080/07399330601180123.

    Article  PubMed  Google Scholar 

  7. Buelna, C., Ulloa, E. C., & Ulibarri, M. D. (2009). Sexual relationship power as a mediator between dating violence and sexually transmitted infections among college women. Journal of Interpersonal Violence, 24(8), 1338–1657. doi:10.1177/088626058322193.

    Article  PubMed  Google Scholar 

  8. Campbell, A. N., Tross, S., Dworkin, S. L., Hu, M. C., Manuel, J., Pavlicova, M., & Nunes, E. V. (2009). Relationship power and sexual risk among women in community-based substance abuse treatment. Journal of Urban Health, 86(6), 951–964. doi:10.1007/s11524-009-9405-0.

  9. Campbell, A. N. C., Tross, S., Hu, M., Pavlicova, M., & Nunes, E. V. (2012). Predictors of relationship power among drug-involved women. AIDS and Behavior, 16, 1532–1541. doi:10.1007/s10461-012-0208-z.

    PubMed Central  Article  PubMed  Google Scholar 

  10. Connell, R. W. (1987). Gender and power. Stanford, CA: Stanford University Press.

    Google Scholar 

  11. Dudgeon, M. R., & Inhorn, M. C. (2004). Men’s influences on women’s reproductive health: Medical anthropological perspectives. Social Science and Medicine, 59(7), 1379–1395. doi:10.1016/j.socscimed.2003.11.035.

    Article  PubMed  Google Scholar 

  12. Dunkle, K. L., Jewkes, R., Brown, H. C., Gray, G. E., McIntryre, J. A., & Harlow, S. D. (2004). Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet, 363(9419), 1415–1421. doi:10.1016/S0140-6736.

    Article  PubMed  Google Scholar 

  13. Dunkle, K. L., Jewkes, R., Nduna, M., Jama Shai, N. J., Levin, J., Sikweyiya, Y., & Koss, M. P. (2007). Transactional sex with casual and main partners among young South African men in the rural Eastern Cape: Prevalence, predictors, and associations with gender-based violence. Social Science & Medicine, 65(6), 1235–1248. doi:10.1016/j.socscimed.2007.04.029.

  14. Emerson, R. M. (1972). Exchange theory part I: A psychological basis for social exchange. In J. Berger, M. J. Selditch, & B. Anderson (Eds.), Sociological theories in progress (Vol. 2, pp. 38–57). Boston: Houghton-Mifflin.

    Google Scholar 

  15. Emerson, R. M. (1981). Social exchange theory. In M. Rosenberg & R. H. Turner (Eds.), Social psychology: Sociological perspectives (pp. 30–65). New York: Basic Books.

    Google Scholar 

  16. Filson, J., Ulloa, E., Runfola, C., & Hokoda, A. (2010). Does powerlessness explain the relationship between intimate partner violence and depression? Journal of Interpersonal Violence, 25(3), 400–415. doi:10.1177/0886260509334401.

    Article  PubMed  Google Scholar 

  17. Flesch, R. (1948). A new readability yardstick. Journal of Applied Psychology, 32, 221–233. doi:10.1037/h0057532.

    Article  PubMed  Google Scholar 

  18. Foss, A. M., Vickerman, P. T., Heise, L., & Watts, C. H. (2003). Shifts in condom use following microbicide introduction: Should we be concerned? AIDS, 17(8), 1227–1237. doi:10.1097/01.aids.0000060388.18106.43.

    Article  PubMed  Google Scholar 

  19. Frye, V., Latka, M. H., Wu, Y., Valverde, E. E., Knowlton, A. R., Knight, K. R., … INSPIRE Study Team. (2007). Intimate partner violence perpetration against main female partners among HIV-positive male injection drug users. Journal of Acquired Immune Deficiency Syndromes, 46(Suppl 2), S101–S109. doi:10.1097/QAI.0b013e31815767e6.

  20. Gagnon, A. J., Merry, L., Bocking, J., Rosenberg, E., & Oxman-Martinez, J. (2010). South Asian migrant women and HIV/STIs: Knowledge, attitudes and practices and the role of sexual power. Health & Place, 16, 10–15. doi:10.1016/j.healthplace.2009.06.009.

    Article  Google Scholar 

  21. Groves, A. K., Kagee, A., Maman, S., Moodley, D., & Rouse, P. (2012). Association between intimate partner violence and emotional distress among pregnant women in Durban, South Africa. Journal of Interpersonal Violence, 27(7), 1341–1356. doi:10.1177/0886260511425247.

    PubMed Central  Article  PubMed  Google Scholar 

  22. Harper, C. C., Minnis, A. M., & Padian, N. S. (2003). Sexual partners and use of emergency contraception. American Journal of Obstetrics and Gynecology, 189(4), 1093–1099. doi:10.1067/S0002-9378(03)00544-1.

    Article  PubMed  Google Scholar 

  23. Harris, K. A., Grant, L. M., Pitter, R., & Brodie, D. A. (2009). Associations between HIV risk, unmitigated communion, and relationship power among African American women. Journal of HIV/AIDS & Social Services, 8(4), 331–351. doi:10.1080/15381500903396865.

    Article  Google Scholar 

  24. Harvey, S. M., & Bird, S. T. (2004). What makes women feel powerful? An exploratory study of relationship power and sexual decision-making with African Americans at risk for HIV/STDs. Women and Health, 39(3), 1–18. doi:10.1300/J013v39n03_01.

    Article  PubMed  Google Scholar 

  25. Hatcher, A. M., Tsai, A. C., Kumbakumba, E., Dworkin, S. L., Hunt, P. W., Martin, J. N., … Weiser, S. D. (2012). Sexual relationship power and depression among HIV-infected women in rural Uganda. PLoS One, 7(12), e49821. doi:10.1371/journal.pone.0049821.

  26. Higgins, J. A., Hoffman, S., & Dworkin, S. L. (2010). Rethinking gender, heterosexual men, and women’s vulnerability to HIV/AIDS. American Journal of Public Health, 100, 435–445. doi:10.2105/AJPH.2009.159723.

    PubMed Central  Article  PubMed  Google Scholar 

  27. Jama Shai, N. P., Jewkes, R., Levin, J., Dunkle, K., & Nduna, M. (2010). Factors associated with consistent condom use among rural young women in South Africa. AIDS Care, 22(11), 1379–1385. doi:10.1080/09540121003758465.

    Article  PubMed  Google Scholar 

  28. Jewkes, R. K., Dunkle, K., Nduna, M., & Jama Shai, N. P. (2010). Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: A cohort study. Lancet, 376(9734), 41–48. doi:10.1016/S0140-6738(10)60548-X.

    Article  Google Scholar 

  29. Jewkes, R., Dunkle, K., Nduna, M., Levin, J., Jama Shai, N. P., Khuzwayo, N., … Duvvury, N. (2006). Factors associated with HIV sero-status in young rural South African women: Connections between intimate partner violence and HIV. International Journal of Epidemiology, 35(6), 1461–1468. doi:10.1093/ije/dyl218.

  30. Jewkes, R., Sikweyiya, Y., Morrell, R., & Dunkle, K. (2011). The relationship between intimate partner violence, rape and HIV amongst South African men: A cross-sectional study. PLoS ONE, 6(9), e24256. doi:10.1371/journal.pone.0024256.

    PubMed Central  Article  PubMed  Google Scholar 

  31. Jones, R., & Gulick, E. (2009). Reliability and validity of the sexual pressure scale for women-revised. Research in Nursing & Health, 32(1), 71–85. doi:10.1002/nur.20297.

    Article  Google Scholar 

  32. Kaufman, M. R., Shefer, T., Crawford, M., Simbayi, L. C., & Kalichman, S. C. (2008). Gender attitudes, sexual power, HIV risk: A model for understanding HIV risk behavior of South African men. AIDS Care, 20(4), 434–441.

    Article  PubMed  Google Scholar 

  33. Kershaw, T. S., Small, M., Joseph, G., Theodore, M., Bateau, R., & Frederic, R. (2006). The influence of power on HIV risk among pregnant women in rural Haiti. AIDS and Behavior, 10(3), 309–318. doi:10.107/s10461-006-9072-z.

    Article  PubMed  Google Scholar 

  34. Ketchen, B., Armistead, L., & Cook, S. (2009). HIV infection, stressful life events, and intimate relationship power: The moderating role of community resources for black South African women. Women and Health, 49(2–3), 197–214. doi:10.1080/03630240902963648.

    PubMed Central  Article  PubMed  Google Scholar 

  35. Knudsen, H., Leukefeld, D. W. W., Havens, J. R., Duvall, J. L., Oser, C. B., Staton-Tindall, M., … Inciardi, J. A. (2008). Partner relationships and HIV risk behaviors among women offenders. Journal of Psychoactive Drugs, 40(4), 471–481. doi:10.1080/02791072.2008.10400653.

  36. Koblin, B. A., Hoover, D. R., Xu, G., Frye, V., Latka, M. H., Lucy, D., & Bonner, S. (2010). Correlates of anal intercourse vary by partner type among substance-using women: Baseline data from the UNITY study. AIDS & Behavior, 14, 132-140. doi:10.1007/s10461-008-9440-y.

  37. Lau, J. T., Yang, X., Wang, Q., Cheng, Y., Tsui, H. Y., Mui, L. W. H., & Kim, J. H. (2006). Gender power and marital relationships as predictors of sexual dysfunction and sexual satisfaction among young married couples in rural China: A population-based study. Urology, 67(3), 579–585. doi:10.1016/j.urology.2005.09.039.

  38. Leukefeld, C., Havens, J., Tindall, M. S., Oser, C. B., Mooney, J., Hall, M. T., & Knudsen, H. K. (2012). Risky relationships: Targeting HIV prevention for women offenders. AIDS Education and Prevention, 24(4), 339–349. doi:10.1521/aeap.2012.24.4.339.

  39. Magee, E. M., Small, M., Frederic, R., Joseph, G., & Kershaw, T. (2006). Determinants of HIV/AIDS risk behaviors in expectant fathers in Haiti. Journal of Urban Health, 83(4), 625–636. doi:10.1007/s11524-006-9063-4.

    PubMed Central  Article  PubMed  Google Scholar 

  40. Maman, S., Campbell, J., Sweat, M. D., & Gielen, A. C. (2000). The intersections of HIV and violence: Directions for future research and interventions. Social Science and Medicine, 50(4), 459–478. doi:10.1016/S0277-9536(99)00270-1.

    Article  PubMed  Google Scholar 

  41. Mosack, K. E., Randolph, M. E., Dickson-Gomez, J., Abbott, M., Smith, E., & Weeks, M. R. (2010). Sexual risk-taking among high-risk urban women with and without histories of childhood sexual abuse: Mediating effects of contextual factors. Journal of Child Sexual Abuse, 19(1), 43–61. doi:10.1080/10538710903485591.

    PubMed Central  Article  PubMed  Google Scholar 

  42. Mosack, K. E., Weeks, M. R., Sylla, L. N., & Abbott, M. (2005). High-risk women’s willingness to try a simulated vaginal microbicide: Results from a pilot study. Women and Health, 42(2), 71–88. doi:10.1300/J013v42n02_05.

    PubMed Central  Article  PubMed  Google Scholar 

  43. Nduna, M., Jewkes, R. K., Dunkle, K. L., Jama Shai, N. P., & Colman, I. (2010). Associations between depressive symptoms, sexual behaviour and relationship characteristics: a prospective cohort study of young women and men in the Eastern Cape, South Africa. Journal of the International AIDS Society, 13, 44. doi:10.1186/1758-2652-13-44.

    PubMed Central  Article  PubMed  Google Scholar 

  44. Nnadi-Okolo, E. E. (1990). Health research design and methodology. CRC Press.

  45. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.

    Google Scholar 

  46. Operario, D., Nemoto, T., Iwamoto, M., & Moore, T. (2011a). Risk for HIV and unprotected sexual behavior in male primary partners of transgender women. Archives of Sexual Behavior, 40(6), 1255–1261. doi:10.1007/s/0508-011-978-x.

    Article  PubMed  Google Scholar 

  47. Operario, D., Nemoto, T., Iwamoto, M., & Moore, T. (2011b). Unprotected sexual behavior and HIV risk in the context of primary partnerships for transgender women. AIDS and Behavior, 15(3), 674–682. doi:10.1007/s/10461-010-9795-8.

    PubMed Central  Article  PubMed  Google Scholar 

  48. Panchanadeswaran, S., Frye, V., Nandi, V., Galea, S., Vlahov, D., & Ompad, D. (2010). Intimate partner violence and consistent condom use among drug-using heterosexual women in New York City. Women and Health, 50(2), 107–124. doi:10.1080/03630241003705151.

    PubMed Central  Article  PubMed  Google Scholar 

  49. Parrado, E. A., Flippen, C. A., & McQuiston, C. (2005). Migration and relationship power among Mexican women. Demography, 42(2), 347–372. doi:10.1353/dem.2005.001.

    Article  PubMed  Google Scholar 

  50. Pettifor, A. E., Measham, D. M., Rees, H. V., & Padian, N. S. (2004). Sexual power and HIV risk. South Africa. Emerging Infectious Diseases, 10(11), 1996–2004. doi:10.3201/eid1011.040252.

    Article  PubMed  Google Scholar 

  51. Powwattana, A. (2009). Sexual behavior model among young Thai women living in slums in Bangkok. Thailand. Asian-Pacific Journal of Public Health, 21(4), 451–460. doi:10.1177/1010539509343971.

    Article  Google Scholar 

  52. Pulerwitz, J., Amaro, H., DeJong, W., Gortmaker, S. L., & Rudd, R. (2002). Relationship power, condom use, and HIV risk among women in the USA. AIDS Care, 14(6), 789–800. doi:10.1080/09540412021000031868.

    Article  PubMed  Google Scholar 

  53. Pulerwitz, J., Gortmaker, S. L., & Dejong, W. (2000). Measuring relationship power in HIV/STD research. Sex Roles, 42, 637–660. doi:10.1023/A:1007051506972.

    Article  Google Scholar 

  54. Ragsdale, K., Gore-Felton, C., Koopman, C., & Seal, D. W. (2009). Relationship power, acculturation, and sexual risk behavior among low-income Latinas of Mexican or Puerto Rican ethnicity. Sexuality Research & Social Policy, 6(1), 56–69. doi:10.1525/srsp.2009.6.1.56.

    Article  Google Scholar 

  55. Rocca, C. H., Doherty, I., Padian, N. S., Hubbard, A. E., & Minnis, A. M. (2010). Pregnancy intentions and teenage pregnancy among Latinas: A mediation analysis. Perspectives on Sexual and Reproductive Health, 42(3), 186–196. doi:10.1363/4218610.

    PubMed Central  Article  PubMed  Google Scholar 

  56. Ronfeldt, H. M., Kimerling, R., & Arias, I. (1998). Satisfaction with relationship power and the perpetration of dating violence. Journal of Marriage and Family, 60(1), 70-78.

  57. Roye, C. F., Krauss, B. J., & Silverman, P. L. (2010). Prevalence and correlates of heterosexual anal intercourse among Black and Latina female adolescents. Journal of the Association of Nurses in AIDS Care, 21(4), 291–301. doi:10.1016/j.jana.2009.12.002.

    PubMed Central  Article  PubMed  Google Scholar 

  58. Roye, C. F., Tolman, D. L., & Snowden, F. (2012). Heterosexual anal intercourse among Black and Latino adolescents and young adults: A poorly understood high-risk behavior. Journal of Sex Research, 50(7), 715–722. doi:10.1080/00224499.2012.719170.

    Article  PubMed  Google Scholar 

  59. Salazar, L. F., Head, S., Crosby, R. A., DiClemente, R. J., Sales, J. M., Wingood, G. M., & Rose, E. (2011). Personal and social influences regarding oral sex among African American female adolescents. Journal of Women’s Health, 20(2), 161–167. doi:10.1089/jwh.2010.2247.

  60. Sayles, J. N., Pettifor, A., Wong, M. D., MacPhail, C., Lee, S., & Hendriksen, E. (2006). Factors associated with self-efficacy for condom use and sexual negotiation among South African youth. Journal of Acquired Immune Deficiency Syndromes, 43(2), 226–233. doi:10.1097/01.qui.0000230527.17459.5.

    PubMed Central  Article  PubMed  Google Scholar 

  61. Sebelius, K. (2011). Report on Activities Related to “Improving Women’s Health” As Required by the Affordable Care Act, (P.L. 111-148, Section 3509).

  62. Shannon, K., Leiter, K., Phaladze, N., Hlanze, Z., Tsai, A. C., Heisler, M.,… Weiser, S. D. (2012). Gender inequity norms are associated with increased male-perpetrated rape and sexual risks for HIV infection in Botswana and Swaziland. PLoS One, 7(1), e28739. doi:10.1371/journal.pone.0028739.

  63. Steffenson, A. E., Pettifor, A. E., Seage, G. R. I., Rees, H. V., & Cleary, P. D. (2011). Concurrent sexual partnerships and human immunodeficiency virus risk among South African youth. Sexually Transmitted Diseases, 38(6), 459–466. doi:10.1097/OLQ.0b013e3182080860.

    PubMed Central  PubMed  Google Scholar 

  64. Tietelman, A. M., Ratcliffe, S. J., Morales-Aleman, M. M., & Sullivan, C. M. (2008). Sexual relationship power, intimate partner violence, and condom use among minority urban girls. Journal of Interpersonal Violence, 23(12), 1694–1712. doi:10.1177/0886260508314331.

    Article  Google Scholar 

  65. Tschann, J. M., Adler, N. E., Millstein, S. G., Gurvey, J. E., & Ellen, J. M. (2002). Relative power between sexual partners and condom use among adolescents. Journal of Adolescent Health, 31(1), 17–25. doi:10.1016/S1054-139X(01)00418-9.

    Article  PubMed  Google Scholar 

  66. Ulibarri, M. D., Strathdee, S. A., Lozada, R., Magis-Rodriguez, C., Amaro, H., O’Campo, P., & Patterson, T. L. (2010). Intimate partner violence among female sex workers in two Mexico-U.S. border cities: Partner characteristics and HIV risk behaviors as correlates of abuse. Psychological Trauma: Theory, Research, Practice and Policy, 2(4), 318-325. doi:10.1037/a0017500.

  67. VanderDrift, L. E., Agnew, C. R., Harvey, S. M., & Warren, T. J. (2013). Whose intentions predict? Power over condom use within heterosexual dyads. Health Psychology, 32, 1038–1046. doi:10.1037/a0030021.

    PubMed  Google Scholar 

  68. Volpe, E. M., Hardie, T. L., & Cerulli, C. (2012). Associations among depressive symptoms, dating violence, and relationship power in urban, adolescent girls. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 41, 506–518. doi:10.1111/j.1552-6909.2012.01384.x.

    PubMed Central  Article  PubMed  Google Scholar 

  69. Weeks, M. R., Li, J., Coman, E., Abbott, M., Sylla, L., Corbett, M., & Dickson-Gomez, J. (2010). Multilevel social influences on female condom use and adoption among women in the urban United States. AIDS Patient Care and STDs, 24(5), 297–309. doi:10.1089/apc.2009.0312.

  70. Wekerle, C., & Wolfe, D. A. (1999). Dating violence in mid-adolescence: theory, significance and emerging prevention initiatives. Clinical Psychology Review, 19(4), 435–456. doi:10.1016/So272-7358(98)00091-9.

    Article  PubMed  Google Scholar 

  71. Wingood, G. M., & DiClemente, R. J. (2000). Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Education & Behavior, 27(5), 539–565. doi:10.1177/10901981002700502.

    Article  Google Scholar 

  72. World Health Organization. (2009). Woman and health: Today’s evidence, tomorrow‘s agenda. Geneva: Switzerland.

    Google Scholar 

  73. Yang, X., & Xia, G. (2006). Gender, work, and HIV risk: Determinants of risky sexual behavior among female entertainment workers in China. AIDS Education and Prevention, 18(4), 333–347. doi:10.1521/aeap.2006.18.4.333.

    Article  PubMed  Google Scholar 

  74. Younge, S. N., Salem, D., & Bybee, D. (2010). Risk revisited: The perception of HIV risk in a community sample of low-income African American women. Journal of Black Psychology, 36(1), 49–74. doi:10.1177/0095798408320633.

    Article  Google Scholar 

  75. Zukoski, A. P., Harvey, S. M., Oakley, L., & Branch, M. (2011). Exploring power and sexual decision making among young Latinos residing in rural communities. Women’s Health Issues, 21(6), 450–457. doi:10.1016/j.whi.2011.05.002.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Funding for this study was provided by a Grant to Dr. McMahon from the National Institutes of Health, National Institute on Drug Abuse (R01DA15641). Further support was provided by the University of Rochester Center for AIDS Research (P30AI078498). Marilyn Nickerson provided technical assistance.

Author information

Affiliations

Authors

Corresponding author

Correspondence to James M. McMahon.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

McMahon, J.M., Volpe, E.M., Klostermann, K. et al. A Systematic Review of the Psychometric Properties of the Sexual Relationship Power Scale in HIV/AIDS Research. Arch Sex Behav 44, 267–294 (2015). https://doi.org/10.1007/s10508-014-0355-6

Download citation

Keywords

  • Sexual Relationship Power Scale
  • Psychometrics
  • HIV
  • AIDS