JMIR Publications

ABSTRACT

Background:

Digital sexual communication strategies (e.g., sexting) may increase adolescents’ confidence to discuss sexual health and negotiate condom use. Because few validated measures for evaluating sexting-based condom negotiation exist, this study created and examined the psychometric properties of a condom use negotiated experiences through technology (CuNET) scale.

Objective:

Examining the psychometric properties of a sexting-based condom negotiation scale.

Methods:

Using peer network sampling, 242 forcibly displaced adolescents (16-19-years) were recruited for participation. A subscale (embarrassment to negotiate condom use) of the Multidimensional Condom Attitudes Scale was adapted to incorporate sexting, yielding CuNET. Participants were randomly assigned to calibration and validation sub-samples to conduct exploratory and confirmatory factor analyses to establish and validate the scale. CuNET measured participants’ support levels for condom negotiation via sexting by gender and associations with sexual health outcomes

Results:

Approximately 25% of respondents reported substantial support for sexting as a condom negotiation strategy. The one-factor CuNET with the validation sample showed a good fit. Adolescent girls showed significantly lower levels of support for using sexting to negotiate condom use (13.60 vs. 21.48, p=.001). Participants who used a condom in the previous three months were more likely to support condom negotiation via sexting than those who did not use condoms (5.16 vs. 2.70, p=.001).

Conclusions:

The unidimensional CuNET scale is (1) valid and reliable for forcibly displaced adolescents living in HIV hyper-endemic settlements in Kampala, (2) gender-sensitive, and (3) relevant for predicting condom use among urban displaced and refugee adolescents. Further development of this scale will enable better understandings of how adolescents are using digital tools for condom negotiation.