Measuring women's sexual autonomy: Development and preliminary validation of the women's sexual autonomy scale.

ABSTRACT

BACKGROUND: Sexual autonomy is an influential component of sexual health risk reduction frameworks, but a universal assessment of sexual autonomy is currently lacking. OBJECTIVES: This study develops and validates the Women's Sexual Autonomy scale (WSA), a comprehensive measure that captures women's perception of their sexual autonomy. DESIGN: Forty-one items were initially created based on current research and in consultation with sexual health experts. In Phase I, a cross-sectional study with 127 women was conducted to finalize the scale. In Phase II, a cross-sectional study with 218 women was conducted to test the stability and validity of the scale. A confirmatory factor analysis was conducted with an independent sample of 218 participants. METHODS: In Phase I, principal component analysis with promax rotation was conducted to examine the factor structure for the sexual autonomy scale. Cronbach's alphas were conducted to assess the internal consistency of the sexual autonomy scale. In Phase II, confirmatory factor analyses were conducted to confirm the factor structure of the scale. Logistic and linear regressions were used to assess validity of the scale. Unwanted condomless sex and coercive sexual risk were used to test construct validity. Intimate partner violence was used to test predictive validity. RESULTS: Exploratory factor analysis identified four factors across 17 items 4 items on sexual cultural scripting (Factor 1), 5 items on sexual communication (Factor 2), 4 items on sexual empowerment (Factor 3), and 4 items on sexual assertiveness (Factor 4). Internal consistency for the total scale and subscales were adequate. The WSA scale showed construct validity by negatively relating to unwanted condomless sex and coercive sexual risk, and predictive validity by negatively relating to partner violence. CONCLUSION: The results of this study suggest the WSA scale provides a valid, reliable assessment of sexual autonomy for women. This measure can be incorporated into future studies investigating sexual health.