HIV暴露前预防认知量表的编制及在男男性行为者中的初步验证

Development and preliminary validation of an HIV pre-exposure prophylaxis stigma scale among men who have sex with men in China

目的编制并验证基于健康行动过程取向理论的PrEP认知量表,为进一步探讨PrEP的认知影响因素和推广机制提供工具。方法以量表的六个主要理论要素(自我效能、积极结果预期、消极结果预期、风险感知、使用意愿和行动计划)构建量表条目池,于2023年10月26日至11月27日在成都和合肥两市的MSM中进行预调查,调查内容包括一般人口学特征、HIV暴露风险、PrEP使用情况以及PrEP认知量表,评估量表的内容效度、表面效度和区分效度,以Cronbach’sα系数评价量表信度,并在一部分调查对象中检测量表的重测信度。结果在参与预调查的32名研究对象中,53.1%(17人)存在HIV暴露风险,34.4%(11人)曾经或正在使用PrEP,在服药方案的选择偏好上,研究对象首选按需服药方案,长效注射方案次之,最后为每日服药方案。由HIV领域专家、同伴领袖和一般适用人群对量表的内容效度和表面效度进行定性评价,修改各条目的措辞和顺序,最终形成9维度44条目PrEP认知量表。总Cronbach’sα为0.882,重测信度组内相关系数为0.895。结论量表的信效度良好,可用于测量PrEP适用人群的PrEP认知水平,为PrEP推广提供评估工具和参考。

Objective This study aimed to develop and validate a pre-exposure prophylaxis(PrEP)stigma scale based on the health action process approach(HAPA),to provide a tool for further exploration of influencing factors and the development of promotion strategies for PrEP.Methods The scale items were derived from the six key theoretical elements of the scale:self-efficacy,positive outcome expectancy,negative outcome expectancy,risk perception,willingness to use,and action plan.A preliminary survey was conducted among men who have sex with men in Chengdu and Hefei from October 26 to November 27,2023,collecting data on demographic characteristics,HIV exposure risk,PrEP usage,and responses to the PrEP stigma scale.Content validity,face validity,and discriminant validity of the scale were assessed.The reliability of the scale was evaluated using Cronbach'sαcoefficient,and test-retest reliability was examined in a subset of participants.Results Among the 32 participants surveyed,53.1%(17/32)reported HIV exposure risk,and 34.4%(11/32)had used or were currently using PrEP.Preferences for medication regimens revealed a preference for on-demand dosing,followed by long-acting injections,and daily medication.Content and face validity of the PrEP stigma scale were quantitatively evaluated by HIV specialists,peer leaders,and the target population,resulting in revisions to item wording and order.The final PrEP stigma scale comprised nine dimensions with 44 items,exhibiting a total Cronbach'sαof 0.882 and a test-retest intragroup correlation coefficient of 0.895.Conclusions The developed scale demonstrated good reliability and validity.It can serve as a valuable tool for assessing PrEP-related attitudes and behaviors,offering guidance for PrEP promotion initiatives.