Condom use measurement in 56 studies of sexual risk behavior: review and recommendations

Despite numerous studies that measure self-reported condom use, there is currently no agreed upon "gold standard" in terms of the best way to assess condom use. The purpose of the current study was to review measures of self-reported condom use within correlational studies of sexual risk behavior, and to evaluate such measures on the basis of suggestions from the methodological literature. An additional purpose was to examine specifically whether measures published in the correlational literature have improved over time. A systematic review of studies was undertaken and specific review criteria were used to guide the inclusion of studies. A final set of 56 studies that contained 72 measures of self-reported condom use were included in the review. These measures were coded and evaluated on 12 dimensions, including measure type, number of response categories, recall period, sex partner specificity, and sex act specificity. Results indicated a great amount of diversity in terms of how condom use has been measured in the literature. Although results indicated that measures published between 1996 and 2003 were of higher quality on a number of dimensions as compared to 1989-1995, a number of these gains were minimal and in some cases measures have decreased in quality. The overall conclusion is that the sexual risk behavior literature should implement more of the recommendations made by methodological scholars in this area. Specific recommendations are summarized and presented in a way that may be helpful in guiding the development of future measures of self-reported condom use.