Assessment of behavioral skills remains critical to the evaluation of HIV prevention interventions; however, investigators often rely upon participant reports of self-efficacy to estimate such skills. We evaluated the relationship between self-efficacy beliefs for condom use and behavioral performance. Forty-three men completed the Condom Use Self-Efficacy Scale (CUSES) and participated in 2 behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to negotiation of condom use did not account for a significant amount of variability in interpersonal skills; similarly, the CUSES subscale relevant to technical condom use skill did not account for variability in the condom application scores. We caution investigators against the assumption that higher self-efficacy reflects behavioral competence for HIV-risk reduction.
PIP: It has been estimated that 1% of young men in the US are infected with HIV. Concern about AIDS has led to the development of theoretical models which address the determinants of behavior change. According to Bandura's self-efficacy theory, self-efficacy informs decisions to engage in risk-reducing behaviors, determines the amount of effort expended, and influences the extent to which an individual perseveres when obstacles are encountered. The Condom Use Self-Efficacy Scale (CUSES) assesses efficacy to purchase condoms, apply and remove them, and negotiate their use with partners. Evidence exists for the reliability of the CUSES. The authors investigated whether perceptions of condom use efficacy measured by the CUSES correlate with related skills when assessed by behavioral role-plays. 43 men completed the CUSES and participated in two behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to the negotiation of condom use did not account for a significant amount of variability in interpersonal skills. Moreover, the CUSES subscale relevant to technical condom use skill did not account for variability in condom application scores. Caution is recommended before assuming that higher self-efficacy reflects behavioral competence for HIV risk reduction.