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Methodology

Psychometric testing of the consequences of an HIV disclosure instrument in Mandarin: a cross-sectional study of persons living with HIV in Hunan, China

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Pages 1451-1459 | Published online: 17 Aug 2018
 

Abstract

Purpose

This study aimed to examine the psychometric properties of a Mandarin-language version of an instrument that assesses the Consequences of HIV Disclosure (CoHD).

Patients and methods

The original CoHD instrument developed by Serovich was translated into Mandarin and administered to a random sample of 184 persons living with HIV (PLWH) using face-to-face and structured interviews. The CoHD instrument required respondents to rate the importance of eight costs (eg, might lose the relationship) and ten rewards (eg, would bring us closer) in their decision about whether to self-disclose their HIV status. The participants were directed to respond with respect to a current (or hypothetical) sexual partner.

Results

Internal consistency was acceptable (Cronbach’s α for the overall scale 0.82, costs 0.71, and rewards 0.86), as was stability (test–retest reliability overall 0.74, cost 0.63, and rewards 0.82). The CVI for the scale was 0.83, with items rated by subject experts ranging from 0.80 to 1.0. To determine structural validity, exploratory factor analysis extracted two subscales consistent with the original CoHD subscales. The Mandarin CoHD scores were significantly correlated with disclosure self-efficacy (indicating convergent validity), but they were unrelated to safer sex efficacy (indicating divergent validity). This criterion was tested by comparing the scores of PLWH who disclosed their HIV status (mean±SD 53.57±9.06) with those who did not disclose it (mean±SD 49.63±7.45); however, the difference was not statistically significant.

Conclusion

The Mandarin version of the CoHD instrument demonstrates promising psychometric properties when assessing costs and rewards with respect to sexual partner disclosure. This suggests that it might be useful in research on partner notification strategies. In further studies, larger and more diverse samples and an analysis of responses for different disclosure targets are warranted. Moreover, whether the CoHD score is related to the decision of disclosure should be determined.

Acknowledgments

The authors thank all the participants for participating in this study. This work was possible due to the support from the National Institute on Drug Abuse at the National Institutes of Health (grant no. R03DA025553). The authors appreciate the contributions from their colleagues, including Lu Zhou, Gangqiao Huang, Yan Jiang, and Zhisheng Liu.

Author contributions

KP Fennie and HH Wang were responsible for the design; XL Xiao, JS Zhao, and CL Tang conducted this study; XL Xiao and KP Fennie analyzed the data; XL Xiao, XH Li, JM Simoni, and HH Wang contributed to writing this paper. All authors contributed toward data analysis, drafting and revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.