Development and Validation of the Power Imbalance in Couples Scale

Abstract

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: χ(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: χ(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.

Study protocol: a pilot randomised waitlist-controlled trial of a dyadic mobile health intervention for black sexual-minority male couples with HIV in the USA

“…Assessments at baseline, 6 months, 8 months and 14 months will be administered online and will measure HIV care engagement using a comprehensive behavioural composite of engagement in HIV care 52 ; engagement and retention in care using the Index of Engagement in HIV Care (eg, “How well do you follow through on your HIV care when things in your life get tough?”) 54 ; and self-reported ART adherence (eg, “In the last 30 days, on how many days did you miss at least one dose of any of your medication?”) 55 and viral suppression (eg, “Was your last viral load detectable or undetectable?”). Guided by our conceptual framework ( figure 1 ), 22 we will measure dyadic capacity using the Dyadic Coping Inventory, 56 Couple Health Support, Partner Support for HIV Treatment 57 and relationship factors using the Power Imbalance in Couples Scale, 58 and the Couple Sexual Satisfaction Scale (Conroy AA, Development and Validation of the Couple Sexual Satisfaction Scale for HIV and Sexual Health Research, Under Review). We will also assess individual-level factors as indicated by our conceptual framework, including the HIV Stigma Scale.…”

Gender, Power, and Health: Measuring and Assessing Sexual Relationship Power Equity Among Young Sub-Saharan African Women and Men, a Systematic Review

“…The two subscales were relationship control and decision-making dominance (Pulerwitz et al, 2000). Although the original scale was developed and validated among women, studies have used the SRPS to understand and measure men’s own practices of controlling behaviors and decision-making dominance (Closson, Dietrich, et al, 2019; Khidir et al, 2019; McMahon et al, 2015; Neilands et al, 2018). To a lesser extent, the scale has also been used to measure men’s perceptions of their primary female partners’ controlling behaviors (Naidoo et al, 2015; Sayles et al, 2006; Steffenson et al, 2011; Teitelman et al, 2016).…”