Measurement matters: Developing a new scale to assess sexual self-esteem

Background: Self-esteem is often used as a global construct to explain HIV-associated risk. Self-esteem has been related to sexual behavior; however, the association is inconclusive, inconsistent and, at times, contradictory. Self-esteem may be more appropriately conceptualized as a domain-specific construct, “sexual self-esteem” for instance. There is, however, little empirical data evaluating the concept of sexual self-esteem. Thus, the objective of this study is to describe the development of the Bradley-DiClemente Sexual Self-Esteem scale (BDSSE), a domain-specific scale for use in HIV/STD prevention research.

Methods: Scale development included concept analysis, item construction and selection of items. This process was informed by researchers and health professionals familiar with self-esteem or the target population. A brief scale was administered via ACASI to 191 African-American adolescent females, ages 14-20, participating in a HIV risk-reduction intervention. Construct validity was assessed using the Rosenberg Self-Esteem Scale (RSES), a global measure of self-esteem, and internal consistency assessed using Cronbach's alpha. The structure of the scale was also assessed using factor analysis.

Results: BDSSE was moderately correlated with the RSES (r=. 31, p<.001) and demonstrated sufficient internal consistency (a=.82). Factor analysis revealed one main factor, with 10 items yielding moderate to high factor loadings (.43 to 82).

Conclusion: Preliminary findings are promising. Future investigations should consider using the 10-item domain-specific measure of sexual self-esteem in HIV/STD research to explain/predict sexual behavior and to evaluate intervention efficacy.