Assessing emotional and behavioral symptoms among South African youth living with HIV: a psychometric analysis of IsiZulu SDQ scale

Abstract

Introduction

Evaluating emotional and behavioral challenges in perinatally HIV-infected youth necessitates culturally tailored tools. While the Strengths and Difficulties Questionnaire (SDQ) gauges psychological traits through 25 items, the isiZulu version’s suitability among this cohort remains uncertain.

Methods

Conducted in South Africa, the study engaged 316 caregiver-youth pairs in the VUKA program and 37 in VUKA_E across six HIV clinics.

Results

The overall SDQ score reliability was acceptable, yet all five sub-scales fell below 0.7 (ranging from 0.26 to 0.59). The peer relationships subscale exhibited the lowest reliability (Cronbach’s α = 0.26). Confirmatory factor analysis revealed poor fits in both 5-factor and 3-factor models, notably in peer problems and hyperactivity constructs.

Discussion

Caution is warranted when using the current Zulu SDQ measurement in a cross-cultural context. An updated version rectifying translation issues is recommended, particularly in hyperactivity and peer problem sub-scales.

Keywords:

• Behavior
• HIV
• SDQ scale
• South Africa
• Youth

Acknowledgments

The authors would like to acknowledge the contributions of the children and caregivers who participated, the VUKA and VUKA EKHAYA research teams who helped to design and implement the interventions, and the clinics and hospitals who partnered with us. We would also like to thank our collaborative partners at the Human Sciences Research Council and the University of KwaZulu-Natal. The protocol for this study is available upon request.

Author contributions

The first author led data curation, formal analysis, methodology, software utilization, and was the primary contributor in drafting the original manuscript. The second author contributed equally to conceptualization, led funding acquisition and resource management, equally contributed to methodology, validation, and shared responsibilities in drafting the original manuscript, reviewing, and editing. The third author contributed equally to conceptualization, provided supporting roles in formal analysis and methodology, assisted in validation, and shared responsibilities in drafting the original manuscript, reviewing, and editing. The fourth author provided supporting roles in conceptualization and equally contributed to reviewing and editing the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.