The Condom Use Self-Efficacy Scale in Substance Use Disorder Treatment-Seeking American Indian Adults

• Published in: Substance use & misuse 2021-08, Vol.56 (13), p.2066-2073
• Main Authors: Serier, Kelsey N., Venner, Kamilla L., Hernandez-Vallant, Alexandra
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Alcohol abuse; American Indian; American Indians; Behavior; Clinical trials; condom use; Confirmatory factor analysis; Cultural values; Drug addiction; Drug use; Fetal alcohol syndrome; Health behavior; Health disparities; Health services utilization; Help seeking behavior; Inequality; Measures; Medical treatment; Native North Americans; psychometric; Risk behavior; Risk factors; Risk reduction; Self-efficacy; Sexual behavior; sexual risk; Sexually transmitted diseases; STD; Substance abuse; Substance abuse treatment; Substance use disorder; substance use disorder treatment; Treatment needs; Unwanted pregnancy
• ISSN: 1082-6084; 1532-2491
• DOI: 10.1080/10826084.2021.1963988

American Indians (AIs) experience substance use disorder and sexual risk related inequities with elevated rates of sexually transmitted infections, unintended pregnancy, and fetal alcohol spectrum disorders. Substance misuse is associated with risky sexual behaviors including condomless sex. Objectives: The current study aimed to test the validity of the Condom Use Self-Efficacy Scale (CUSES) and the relationship between self-efficacy and condom use behaviors in AI individuals with substance use disorders (SUDs). Exploratory analyses also examined changes in condom use self-efficacy across SUD treatment. Methods: As part of a larger randomized controlled trial, AI individuals (N = 79) seeking SUD treatment completed baseline measures of condom use self-efficacy and sexual risk behaviors. Results: Confirmatory factor analysis (CFA) indicated that a 3-factor, 10-item version of the CUSES was a reliable and valid measure in this population. Condom use self-efficacy was associated with condom use behavior and increased during SUD treatment. Conclusions: Overall, it appears that the CUSES is a valid measure in AI individuals, is related to condom use behavior, and increases with SUD treatment. There is a need for future research to integrate these findings into AI cultural values. Addressing sexual risk behaviors in SUD treatment may be an important target and future research is needed to understand predictors of condom use self-efficacy and determine potential intervention targets to reduce sexual risk behaviors and related health inequities.