Introduction
The Health Protective Sexual Communication Scale (HPSC) is a 10-item self-report scale that measures how often a person discusses safer-sex and health-protective topics with a new or prospective sexual partner, especially before first intercourse. Joseph A. Catania developed it, and it was published in 1998.
The HPSC rests on the idea that people's willingness to discuss sexual risks with a partner is linked to protective behaviors such as condom use. This guide explains its items, scoring and validation.
Key Features of the Health Protective Sexual Communication Scale (HPSC)
Purpose and Use
The HPSC quantifies a person's propensity to discuss safer-sex and health-protective topics with new partners. It focuses on the content of the conversations that precede or accompany sexual activity, rather than on the sexual activities themselves.
Target Population
The HPSC is used with adults and adolescents.
Structure
The expanded original version has 10 items covering these content areas:
Condom use: the partner's attitude toward condoms and communicating that condoms are requiredSexual history: the partner's number of previous partners and disclosing one's own historyHIV prevention: HIV testing before intercourseSTI history: whether the partner has had a sexually transmitted infectionInjection drug use: the partner's history of injection drug useSexual experiences: previous same-sex experiences (this item may be excluded for some populations)Sexual decision-making: delaying intercourse until the partners know each other betterContraception: birth-control methodsThese are content areas, not formally validated subscales.
Scoring Method
Items are answered on a 4-point frequency scale: 1 = never, 2 = sometimes, 3 = almost always and 4 = always. "Don't know" and "declined to answer" are offered as non-substantive options and are not scored as higher ratings.
Total score: the sum of the item scores or, in some studies, the mean item score.Higher scores indicate more frequent health-protective sexual communication. There is no established clinical cut-off; the scale is generally used as a continuous research measure. The number of response options varies across versions and studies.
Administration Format
The HPSC is a self-report questionnaire.
Applications of the Health Protective Sexual Communication Scale (HPSC)
The HPSC supports several uses:
Sexual health research: measuring safer-sex communication with new partners.HIV and STI prevention: evaluating prevention programs, such as an HIV prevention intervention for Chilean women.Health promotion: studying communication about condoms and contraception.Languages and availability
The HPSC has been validated among young adults in the United Kingdom and Spain, and used in an HIV prevention intervention in Chile. The scale is described in the Handbook of Sexuality-Related Measures.
Reliability and Validity
The HPSC has been validated among young adults in the United Kingdom and Spain, and it has been used as an outcome or correlate measure in sexual health research.
Validation studies:
Validation of the HPSC among young adults in the United Kingdom and Spain (2024): study linkMeasurement of nontraditional sexuality in women (2012): study linkMano a Mano-Mujer: an effective HIV prevention intervention for Chilean women (2012): study linkLimitations and Considerations
Keep these points in mind:
Version differences: the number of items and response options varies across versions and studies, so report which version you used.No subscales: the content areas are not formally validated subscales.No cut-off: there is no established clinical cut-off score.Population fit: some items may be excluded for particular groups, following the original instructions.Other Versions And Related Questionnaires
The original short version used items 1, 2 and 4. According to the original instructions, items 9 and 10 are excluded for gay men and lesbians.
These questionnaires are related:
Dyadic Sexual Communication Scale (DSCS)Sexual Communication Self-Efficacy Scale (SCSES)Sexual Communication Patterns Questionnaire (SCPQ)Verbal and Nonverbal Sexual Communication Questionnaire (VN-SCQ)Sexual Self-Disclosure Scale and Assertive Sexual Communication ScaleHIV Disclosure Attitudes, Behaviors and Intention ScalesAdditional Resources
The HPSC in the Handbook of Sexuality-Related Measures: linkFor inquiries, contact Joseph A. Catania at Joseph.Catania@oregonstate.edu.Browse more public health questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Health Protective Sexual Communication Scale measure?The HPSC measures how often a person discusses safer sex with a new partner, including condom use, sexual history, HIV testing, STI history, injection drug use and contraception.
How is the HPSC scored?Items are rated from 1 (never) to 4 (always). The item scores are summed, or averaged in some studies, and higher scores mean more frequent health-protective sexual communication.
Does the HPSC have a cut-off score?No. The HPSC has no established clinical cut-off score. It is generally used as a continuous measure in sexual health research.
Who developed the HPSC?Joseph A. Catania developed the Health Protective Sexual Communication Scale, and it was published in 1998. It has since been validated among young adults in the United Kingdom and Spain.
A Word from ResRef About the Health Protective Sexual Communication Scale (HPSC)
The Health Protective Sexual Communication Scale is a well-established measurement tool developed to address a gap in sexual health research. It is built on a straightforward premise: an individual's willingness and ability to discuss sexual risks with a partner is a strong predictor of actual protective behaviors, particularly condom use. Rather than simply asking people about their sexual activities, the HPSC focuses on the content of the conversations that precede or accompany those activities, including sexual history, STI testing, condom use and a partner's history of injection drug use, with higher scores reflecting a greater tendency to initiate protective sexual communication.
References
Alonso-Martínez, L., Forrest, S., Heras-Sevilla, D., Sáiz-Manzanares, M. C., Puente-Alcaraz, J., & Fernández-Hawrylak, M. (2024). Validation of the Health Protective Sexual Communication Scale Among Young Adults in the United Kingdom and Spain. Journal of Nursing Measurement. https://doi.org/10.1891/JNM-2022-0113Levant, R. F., Rankin, T. J., Hall, R. J., Smalley, K. B., & Williams, C. M. (2012). Measurement of nontraditional sexuality in women. Archives of Sexual Behavior, 41(1), 283–95. https://doi.org/10.1007/s10508-011-9793-6Cianelli, R., Ferrer, L., Norr, K. F., Miner, S., Irarrazabal, L., Bernales, M., Peragallo, N., Levy, J., Norr, J. L., & McElmurry, B. (2012). Mano a Mano-Mujer: an effective HIV prevention intervention for Chilean women. Health Care for Women International, 33(4), 321–41. https://doi.org/10.1080/07399332.2012.655388