Cross-cultural validation of the multidimensional condom attitude scale (MCAS) in youth from the United States, Spain, and Latin America.

BackgroundCondoms remain among the most effective methods for preventing HIV and other sexually transmitted infections (STIs). However, consistent use among youth remains suboptimal worldwide. This study aimed to evaluate the psychometric properties and cross-cultural measurement invariance of the Multidimensional Condom Attitude Scale (MCAS) among young adults from 11 countries.MethodsA total of 5656 participants aged 18-26 years from ten Spanish-speaking countries and the United States completed the MCAS online. Confirmatory factor analyses and multigroup invariance testing were performed using the Weighted Least Squares Mean and Variance Adjusted estimator. Reliability was examined with Cronbach's α for the total sample and by biological sex and sexual experience.ResultsThe five-factor structure of the MCAS showed good model fit across all countries, exceeding recommended thresholds (CFI > .95, RMSEA < 0.05; observed CFI > 0.97, RMSEA < 0.04). Strong, though not strict, measurement invariance was established across cultural contexts and sexes. Reliability coefficients were acceptable to high (α = 0.66-0.94). Cross-country differences in attitudes were small, whereas sex-based differences, particularly in stigma, shame, and pleasure, were more pronounced.ConclusionsFindings confirm the MCAS as a valid and reliable tool for assessing condom-related attitudes across diverse cultural settings. The demonstrated invariance supports its use in global research, sexuality education, and HIV prevention initiatives extending beyond Western, Educated, Industrialized, Rich, and Democratic contexts (WEIRD) contexts.