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Evangeli M, Kaleva I, Agyemang A, Williams I, Chawatama T, Jackson R, Keakantse M, Morake B, Seipone K, Busang L. Cultural adaption, translation, preliminary reliability and validity of psychological and behavioural measures for adolescents living with HIV in Botswana: A multi-stage approach. J Health Psychol 2024:13591053241248944. [PMID: 38807436 DOI: 10.1177/13591053241248944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
Human immunodeficiency virus (HIV) remains a significant public health issue among young people living in Botswana. There is a need for reliable and valid psychological and behavioural measures of causally important constructs for this population. We developed a new HIV knowledge measure for use with 10-19-year-olds living with HIV and translated and adapted additional tools measuring HIV adjustment, HIV disclosure cognitions and affect, HIV communication beliefs, antiretroviral (ART) adherence, and self-esteem, using a multi-step process. This included (1) item generation for the HIV knowledge questionnaire, (2) translation including back-translation and expert review, (3) cognitive interviewing, (4) reliability testing (5) preliminary validity analysis. The HIV Knowledge Questionnaire for Adolescents living with HIV, the Illness Cognition Questionnaire, the Adolescent HIV Disclosure Cognition and Affect Scale, the HIV Communication Beliefs Scale, and the Rosenberg Self-Esteem Scale showed acceptable or good reliability and some evidence of validity for adolescents living with HIV in Botswana.
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Affiliation(s)
| | | | | | - Ivor Williams
- African Comprehensive HIV/AIDS Partnerships (ACHAP), Botswana
| | | | - Rachel Jackson
- African Comprehensive HIV/AIDS Partnerships (ACHAP), Botswana
| | | | | | - Khumo Seipone
- African Comprehensive HIV/AIDS Partnerships (ACHAP), Botswana
| | - Lesego Busang
- African Comprehensive HIV/AIDS Partnerships (ACHAP), Botswana
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A peer group intervention implemented by community volunteers increased HIV prevention knowledge. BMC Public Health 2023; 23:301. [PMID: 36765344 PMCID: PMC9912512 DOI: 10.1186/s12889-022-14715-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/23/2022] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND HIV prevention knowledge levels are low in sub-Saharan Africa. In our efficacy study, the Mzake ndi Mzake (Friend-to-Friend; hereafter Mzake) 6-session peer group intervention, delivered by health workers, improved HIV prevention knowledge and other outcomes in Malawi. To expand HIV prevention approaches, this implementation study tested whether the intervention remained effective when implemented by trained community volunteers. HIV prevention knowledge findings are presented. METHODS Using a stepped wedge design, three communities implemented the Mzake program sequentially in randomly assigned order. Repeated surveys assessed outcomes, and participants served as controls until they completed the program. At Time 2, Community 1 became the intervention group, and at Time 3, Communities 1 and 2 were the intervention group. HIV prevention knowledge, the primary outcome, was assessed through two indicators: UNAIDS comprehensive knowledge (UNAIDS Knowledge), defined as correctly answering five HIV prevention questions (Yes/No), and a 9-item HIV/PMTCT Knowledge Index (number correct). Multivariate generalized estimating equation logistic regression (UNAIDS Knowledge) and mixed-effects regression models (HIV/PMTCT Knowledge Index) were used to assess knowledge controlling for five sociodemographic factors. RESULTS In bivariate analyses of UNAIDS Knowledge, more persons answered correctly in the intervention group than the control group at Time 2 (56.8% vs. 47.9%, p < 0.01), but the difference was not significant at Time 3. In logistic regression, there was a significant linear increase in the proportion who correctly answered all questions in the control group, but the increase was significantly higher in the intervention group (log-odds estimate = 0.17, SE = 0.06, p-value < 0.01). The HIV/PMTCT Knowledge Index scores increased over time for both groups, but in the intervention group the increase was significantly higher than the control group (0.11 at Time 2; 0.21 at Time 3). In youth and adult subsamples analyses, the intervention was highly effective in increasing knowledge for youth, but not for adults. CONCLUSION This implementation study showed that Mzake was effective in increasing HIV prevention knowledge when delivered by community members. Community approaches offer an important strategy to increase HIV prevention in rural communities without burdening healthcare systems. TRIAL REGISTRATION ClinicalTrials.gov NCT02765659. Registered 06/05/2016.
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Stewart JL, Wallace DD, Nance A, Schalkoff CA, Uhrig Castonguay BJ, Widman L, Carey MP, Golin CE. Validated HIV Knowledge Scales for Use with Adults and Adolescents: A Systematic Review. AIDS Behav 2022; 26:1695-1715. [PMID: 34729670 DOI: 10.1007/s10461-021-03521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2021] [Indexed: 11/30/2022]
Abstract
HIV knowledge - the information a person possesses about HIV - is essential for the prevention and management of HIV. Therefore, the accurate measurement of HIV knowledge is important for both science and practice. This systematic review identifies extant HIV knowledge scales that have been validated with adolescent and adult populations and summarizes the state of this research. We searched seven electronic databases, which resulted in 6,525 articles. After title/abstract and full-text review, 27 studies remained and underwent qualitative review of reported scale psychometric properties. Many studies were conducted in the last decade (n = 12), reflecting advances in scientific knowledge of HIV. Five were exclusively adolescent-based studies (sample age ≤ 18). Most studies reported reliability (n = 25) or at least one form of validity (n = 21). Future studies should develop or refine HIV knowledge scales so that they reflect recent scientific developments, use rigorous psychometric testing, and target samples that include those persons at highest risk for HIV.
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Affiliation(s)
- J L Stewart
- Applied Social and Community Psychology Program, Department of Psychology, North Carolina State University, 640 Poe Hall, Campus, Box 7650, Raleigh, NC, 27695-7650, USA.
| | - Deshira D Wallace
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, 135 Dauer Drive, CB7440, Chapel Hill, NC, 27599, USA
| | - Abby Nance
- Applied Social and Community Psychology Program, Department of Psychology, North Carolina State University, 640 Poe Hall, Campus, Box 7650, Raleigh, NC, 27695-7650, USA
| | - Christine A Schalkoff
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, 135 Dauer Drive, CB7440, Chapel Hill, NC, 27599, USA
| | - Breana J Uhrig Castonguay
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 100 Manning Drive, Chapel Hill, NC, 27599, USA
| | - Laura Widman
- Applied Social and Community Psychology Program, Department of Psychology, North Carolina State University, 640 Poe Hall, Campus, Box 7650, Raleigh, NC, 27695-7650, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
| | - Carol E Golin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, 135 Dauer Drive, CB7440, Chapel Hill, NC, 27599, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 100 Manning Drive, Chapel Hill, NC, 27599, USA
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Rewley J, Fawzi MCS, McAdam K, Kaaya S, Liu Y, Todd J, Andrew I, Onnela JP. Evaluating spillover of HIV knowledge from study participants to their network members in a stepped-wedge behavioural intervention in Tanzania. BMJ Open 2020; 10:e033759. [PMID: 33033007 PMCID: PMC7542922 DOI: 10.1136/bmjopen-2019-033759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We aim to describe the social network members of participants of a behavioural intervention, and examine how the effects of the intervention may spillover among network members. DESIGN Secondary analysis of a step-wedge randomised controlled trial. SETTING Change agents (CAs) were recruited from waiting rooms of HIV treatment facilities in Dar es Salaam, Tanzania, and their network members (NMs) were recruited directly by CAs. PARTICIPANTS We enrolled 662 CAs in an HIV behavioural intervention. They, along with 710 of their NMs, completed baseline and follow-up interviews from 2011 to 2013. PRIMARY AND SECONDARY OUTCOMES The primary outcome of this study was change in NMs' HIV knowledge, and the secondary outcome was whether the NM was lost to follow-up. RESULTS At baseline, many characteristics were different between NMs and CAs. We found a number of NM characteristics significantly associated with follow-up of NMs, particularly female gender (OR=1.64, 95% CI: 1.02 to 2.63) and HIV knowledge (OR=20.0, 95% CI: 3.70 to 125); only one CA variable was significantly associated with NM follow-up: having a private source of water (OR=2.17, 95% CI: 1.33 to 3.57). The 14.2% increase in NMs' HIV knowledge was largely due to CAs feeling empowered to pass on prior knowledge, rather than transmitting new knowledge to their NMs. CONCLUSIONS Characteristics of social network members of persons living with HIV persons living with HIV may play a role in study retention. Additionally, the HIV knowledge of these NMs increased largely as a function of CA participation in the intervention, suggesting that intervening among highly-connected individuals may maximise benefits to the potential population for whom spillover can occur. TRIAL REGISTRATION NUMBER Clinical Trial: NCT01693458; Post-results.
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Affiliation(s)
- Jeffrey Rewley
- Center for Health Care Innovation, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- CHERP, Philadelphia VAMC, Philadelphia, Pennsylvania, USA
| | - Mary C Smith Fawzi
- Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Keith McAdam
- Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Sylvia Kaaya
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Yuanyuan Liu
- University of Texas School of Public Health, Austin, Texas, USA
| | - Jim Todd
- Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Irene Andrew
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Jukka Pekka Onnela
- Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Evangeli M, Lut I, Ely A. A longitudinal evaluation of an intensive residential intervention (camp) for 12-16 year olds living with HIV in the UK: evidence of psychological change maintained at six month follow-up. AIDS Care 2018; 31:85-89. [PMID: 30045639 DOI: 10.1080/09540121.2018.1503635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There are large numbers of young people with HIV globally, the majority of whom have perinatally acquired HIV (PAH). Despite evidence of lower levels of wellbeing in young people with PAH compared to HIV unaffected peers, there are few psychosocial interventions for this population. Residential interventions (camps) for young people with HIV have the potential for enhancing well-being and improving HIV-related outcomes. There have not been any quantitative evaluations of camps for young people with HIV. This study evaluated a week-long intensive residential intervention for 12-16 year olds living with HIV in the UK. A quantitative repeated measures design was used. Forty nine participants completed assessments before and immediately after the intervention (post-intervention) and at six month follow-up (73% retention rate; 28 (57%) female; median age 14 years, IQR 13-15 years). Self-report measures suggested improvements in both HIV knowledge and pro HIV disclosure affect and cognitions post-intervention, maintained at six month follow-up. There were improvements in antiretroviral adherence beliefs from baseline to six month follow-up, and in self-perception from baseline to post-intervention. These changes are important in their own right but may also be mediators of other outcomes such as increased ART adherence and reduced onward HIV transmission risk. The study suggests that brief residential interventions have the potential to facilitate sustained change in psychological outcomes. Research and practice implications are outlined.
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Affiliation(s)
- Michael Evangeli
- a Department of Psychology , Royal Holloway University of London , Egham , UK
| | - Irina Lut
- a Department of Psychology , Royal Holloway University of London , Egham , UK
| | - Amanda Ely
- b Children's HIV Association (CHIVA) , Children's HIV Association , Bristol , UK
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Gonsalves L, Hindin MJ, Bayer A, Carcamo CP, Gichangi P, Habib N, Mwaisaka J, Say L. Protocol of an open, three-arm, individually randomized trial assessing the effect of delivering sexual and reproductive health information to young people (aged 13-24) in Kenya and Peru via mobile phones: adolescent/youth reproductive mobile access and delivery initiative for love and life outcomes (ARMADILLO) study stage 2. Reprod Health 2018; 15:126. [PMID: 29996854 PMCID: PMC6042417 DOI: 10.1186/s12978-018-0568-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/02/2018] [Indexed: 11/27/2022] Open
Abstract
Background Young people face special challenges to accessing needed sexual and reproductive health (SRH) information and support. With high penetration and access, mobile phones provide a new channel for reaching young people, but there is little evidence around the impact of digital interventions on improving health outcomes. The Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) study will assess the effect of an intervention providing SRH information to young people via text message on their mobile phones in Kenya and Peru. This protocol details an open, individually-randomized, three-arm trial lasting seven weeks to assess the effect of the ARMADILLO intervention on dispelling myths and misconceptions related to contraception. A secondary objective is to determine whether youth given access to SRH information via text message can accurately retain that information. Methods Following a household enumeration, one eligible youth per household will be randomly selected for participation and randomized by computer into one of the three arms. Intervention arm participants will receive access to ARMADILLO content, control participants will receive no information, and ‘Arm 3’ participant interactions will vary by site: in Kenya, they will be alerted to various SRH domains and encouraged to learn on their own; in Peru, they will receive key content from each domain with the option to learn more if they wish. Participants will complete multiple-choice questionnaires administered by data collectors at baseline (prior to randomization), at intervention-period end (after week seven), and eight weeks after timing out of the intervention period. Discussion Part of the Sustainable Development Goal commitment towards ensuring healthy lives and promoting well-being for all at all ages includes a commitment to ‘ensuring universal access to sexual health and reproductive health-care services, including for family planning, information and education’. If proven to be effective, interventions like ARMADILLO can bridge an important gap towards achieving universal access to SRH information and education for an otherwise difficult-to-reach group. Trial registration This trial was retrospectively registered with the ISRCTN Registry and assigned registration number ISRCTN85156148 on 29 May, 2018.
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Affiliation(s)
- Lianne Gonsalves
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland.
| | - Michelle J Hindin
- Population Council, Department of Reproductive Health, 1 Dag Hammarskjold Plaza, New York, NY, 10017, USA
| | - Angela Bayer
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru
| | - Cesar P Carcamo
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru
| | - Peter Gichangi
- International Centre for Reproductive Health Kenya, P.O. Box 91109-80103, Mombasa, Kenya.,Department of Human Anatomy, University of Nairobi, P. O. Box 30197, Nairobi, 00100, Kenya.,Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Ndema Habib
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland
| | - Jefferson Mwaisaka
- International Centre for Reproductive Health Kenya, P.O. Box 91109-80103, Mombasa, Kenya
| | - Lale Say
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland
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Janulis P, Newcomb ME, Sullivan P, Mustanski B. Evaluating HIV Knowledge Questionnaires Among Men Who Have Sex with Men: A Multi-Study Item Response Theory Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:107-119. [PMID: 28488126 PMCID: PMC5680146 DOI: 10.1007/s10508-016-0910-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/19/2016] [Accepted: 11/21/2016] [Indexed: 05/14/2023]
Abstract
Knowledge about the transmission, prevention, and treatment of HIV remains a critical element in psychosocial models of HIV risk behavior and is commonly used as an outcome in HIV prevention interventions. However, most HIV knowledge questions have not undergone rigorous psychometric testing such as using item response theory. The current study used data from six studies of men who have sex with men (MSM; n = 3565) to (1) examine the item properties of HIV knowledge questions, (2) test for differential item functioning on commonly studied characteristics (i.e., age, race/ethnicity, and HIV risk behavior), (3) select items with the optimal item characteristics, and (4) leverage this combined dataset to examine the potential moderating effect of age on the relationship between condomless anal sex (CAS) and HIV knowledge. Findings indicated that existing questions tend to poorly differentiate those with higher levels of HIV knowledge, but items were relatively robust across diverse individuals. Furthermore, age moderated the relationship between CAS and HIV knowledge with older MSM having the strongest association. These findings suggest that additional items are required in order to capture a more nuanced understanding of HIV knowledge and that the association between CAS and HIV knowledge may vary by age.
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Affiliation(s)
- Patrick Janulis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA.
| | - Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
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Washington TA, Applewhite S, Glenn W. Using Facebook as a Platform to Direct Young Black Men Who Have Sex With Men to a Video-Based HIV Testing Intervention: A Feasibility Study. URBAN SOCIAL WORK 2017; 1:36-52. [PMID: 29276800 PMCID: PMC5737932 DOI: 10.1891/2474-8684.1.1.36] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A randomized control pilot study was conducted with Black men who have sex with men (BMSM; N = 42) aged 18-30 years to examine the feasibility of implementing a video intervention delivered using Facebook to motivate HIV testing. METHODS At baseline, participants were unaware of their HIV status and had not tested for HIV in the past 6 months, residing in Los Angeles County. The intervention content included topics such as social influence, HIV knowledge, stigma, HIV positive knowledge, and benefits of knowing one's HIV status. FINDINGS Logistic regression revealed that those receiving the video intervention were 7 times more likely to have tested for HIV than those in the control group at 6-week follow-up (odds ratio [OR] = 7.00, 95% confidence interval [1.72, 28.33], p = .006). CONCLUSION Data suggest that the intervention was feasible for motivating HIV testing.
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Affiliation(s)
- Thomas Alex Washington
- College of Health and Human Services, School of Social Work, California State University, Long Beach, CA, USA
| | - Sheldon Applewhite
- Department of Sociology, Borough of Manhattan Community College, City University of New York, New York, NY, USA
| | - Wendell Glenn
- ADAM Project, Behavioral Health Services, Long Beach, CA, USA
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Prati G, Zani B, Pietrantoni L, Scudiero D, Perone P, Cosmaro L, Cerioli A, Oldrini M. Psychometric Properties of a New HIV/AIDS Knowledge Measure for Adults. SOCIAL WORK IN PUBLIC HEALTH 2015; 31:30-42. [PMID: 26674412 DOI: 10.1080/19371918.2015.1087911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to develop a new 29-item HIV/AIDS knowledge measure and to examine its psychometric properties for three samples of adults: non-HIV-positive heterosexual people, non-HIV-positive men who have sex with men (MSM), and people living with HIV/AIDS (PLWHA). The authors collected data using an online questionnaire. A total of 9,349 Italian individuals agreed to participate in the study: 694 individuals (7.4%) were PLWHA, 5,232 (56.0%) were HIV negative, and the remaining 3,423 (36.6%) were MSM. Using two-parameter item response theory analysis, a bifactor model was found to be better fitting than a one-factor model or a 12 correlated first-order factor model. Differential item functioning showed evidence of measurement nonequivalence of the instrument for the three samples of adults. The reliability of HIV/AIDS knowledge scale among PLWHA was satisfactory. Criterion-related validity was only achieved among non-HIV-positive heterosexual people, non-HIV-positive MSM, as the HIV/AIDS knowledge scale was related with attitudes toward condom use, condom use with casual partners, unknown HIV status of partner, and HIV stigma. Among non-HIV-positive heterosexual people, the HIV/AIDS knowledge scale adds to the prediction of condom use above that of attitudes toward condom use scale. The HIV/AIDS knowledge scale is especially discriminating at low to medium levels of knowledge.
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Affiliation(s)
- Gabriele Prati
- a Department of Psychology , University of Bologna , Cesena , Italy
| | - Bruna Zani
- a Department of Psychology , University of Bologna , Cesena , Italy
| | - Luca Pietrantoni
- a Department of Psychology , University of Bologna , Cesena , Italy
| | - Diego Scudiero
- b LILA (Italian League for the Fight Against AIDS), Como , Italy
| | - Patrizia Perone
- b LILA (Italian League for the Fight Against AIDS), Como , Italy
| | - Lella Cosmaro
- b LILA (Italian League for the Fight Against AIDS), Como , Italy
| | | | - Massimo Oldrini
- b LILA (Italian League for the Fight Against AIDS), Como , Italy
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Adolescents' Communication with Parents, Other Adult Family Members and Teachers on Sexuality: Effects of School-Based Interventions in South Africa and Tanzania. AIDS Behav 2015; 19:2162-76. [PMID: 25724974 DOI: 10.1007/s10461-015-1019-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cluster-randomized controlled trials were carried out to examine effects on sexual practices of school-based interventions among adolescents in three sites in sub-Saharan Africa. In this publication, effects on communication about sexuality with significant adults (including parents) and such communication as a mediator of other outcomes were examined. Belonging to the intervention group was significantly associated with fewer reported sexual debuts in Dar es Salaam only (OR 0.648). Effects on communication with adults about sexuality issues were stronger for Dar es Salaam than for the other sites. In Dar, increase in communication with adults proved to partially mediate associations between intervention and a number of social cognition outcomes. The hypothesized mediational effect of communication on sexual debut was not confirmed. Promoting intergenerational communication on sexuality issues is associated with several positive outcomes and therefore important. Future research should search for mediating factors influencing behavior beyond those examined in the present study.
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Wubs AG, Aarø LE, Kaaya S, Onya H, Mathews C. Social Cognition Variables and Victimization as Predictors of Sexual Debut Among Adolescents in South Africa and Tanzania: A Multi-group SEM Analysis. AIDS Behav 2015; 19:2141-51. [PMID: 25957857 DOI: 10.1007/s10461-015-1087-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Early sexual debut is common in South Africa and Tanzania, with potentially negative reproductive health outcomes. The role of violence as a predictor of sexual debut was studied, in a context of predictors borrowed from social cognition models. Data were taken from cluster-randomized trials of school-based HIV prevention interventions in three sites in South Africa and Tanzania. Analyses consisted of descriptive statistics and multi-group structural equation modelling. The basic model functioned fairly well for Cape Town, but less well for Mankweng and Dar es Salaam (low R(2) values). Attitudes were the strongest predictor of intention. Adding socio-demographic variables to the model did not reduce the associations much and neither did subsequent inclusion of violence. Sexual debut was strongly associated with victimization; adding violence also substantially increased R(2) for sexual debut. Besides social cognition factors, intimate partner violence should be addressed in future research on reproductive health interventions for adolescents.
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Affiliation(s)
- Annegreet Gera Wubs
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Postboks 7800, 5020, Bergen, Norway.
| | - Leif Edvard Aarø
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Postboks 7800, 5020, Bergen, Norway
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sylvia Kaaya
- Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Hans Onya
- Health Promotion Unit, School of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Adolescent Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Gomes RRDFM, Batista JR, Ceccato MDGB, Kerr LRFS, Guimarães MDC. HIV/AIDS knowledge among men who have sex with men: applying the item response theory. Rev Saude Publica 2015; 48:206-15. [PMID: 24897041 PMCID: PMC4206150 DOI: 10.1590/s0034-8910.2014048004911] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 11/12/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the level of HIV/AIDS knowledge among men who have sex with men in Brazil using the latent trait model estimated by Item Response Theory. METHODS Multicenter, cross-sectional study, carried out in ten Brazilian cities between 2008 and 2009. Adult men who have sex with men were recruited (n = 3,746) through Respondent Driven Sampling. HIV/AIDS knowledge was ascertained through ten statements by face-to-face interview and latent scores were obtained through two-parameter logistic modeling (difficulty and discrimination) using Item Response Theory. Differential item functioning was used to examine each item characteristic curve by age and schooling. RESULTS Overall, the HIV/AIDS knowledge scores using Item Response Theory did not exceed 6.0 (scale 0-10), with mean and median values of 5.0 (SD = 0.9) and 5.3, respectively, with 40.7% of the sample with knowledge levels below the average. Some beliefs still exist in this population regarding the transmission of the virus by insect bites, by using public restrooms, and by sharing utensils during meals. With regard to the difficulty and discrimination parameters, eight items were located below the mean of the scale and were considered very easy, and four items presented very low discrimination parameter (< 0.34). The absence of difficult items contributed to the inaccuracy of the measurement of knowledge among those with median level and above. CONCLUSIONS Item Response Theory analysis, which focuses on the individual properties of each item, allows measures to be obtained that do not vary or depend on the questionnaire, which provides better ascertainment and accuracy of knowledge scores. Valid and reliable scales are essential for monitoring HIV/AIDS knowledge among the men who have sex with men population over time and in different geographic regions, and this psychometric model brings this advantage.
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Burke HM, Fleming PJ, Guest G. Assessment of the psychometric properties of HIV knowledge items across five countries. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:577-87. [PMID: 25490737 PMCID: PMC6626987 DOI: 10.1521/aeap.2014.26.6.577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
HIV knowledge is commonly measured in HIV prevention research and program evaluations, but rigorous measurement standards are not always applied. Using item response theory methods, we examined the psychometric functioning of five commonly used HIV knowledge questions in five countries with varying HIV prevalence. We evaluated the internal consistency and measurement invariance of the items. The items performed poorly in all samples and the scale as a whole did not perform equally across samples. We conclude that current ways of measuring HIV knowledge are not adequate and recommend new items be developed, tested, and validated using psychometric methods.
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