Validity,reliability,and measurement invariance of an adapted short version of the HIV stigma scale among perinatally HIV infected adolescents at the Kenyan coast

Background:There is a dearth of instruments that have been developed and validated for use with children living with HIV under the age of 17 years in the Kenyan context.We examined the psychometric properties and measure-ment invariance of a short version of the Berger HIV stigma scale administered to perinatally HIV-infected adolescents in a rural setting on the Kenyan coast.Methods:A cross-sectional study was conducted among 201 perinatally HIV-infected adolescents aged 12-17 years between November 2017 and October 2018.A short version of the Berger HIV stigma scale(HSS-40)containing twelve items(HSS-12)covering the four dimensions of stigma was evaluated.The psychometric assessment included exploratory factor analysis,confirmatory factor analysis(CFA),and multi-group CFA.Additionally,scale reliability was evaluated as internal consistency by calculating Cronbach’s alpha.Results:Evaluation of the reliability and construct validity of the HSS-12 indicated insufficient reliability on three of the four subscales.Consequently,Exploratory Factor Analysis(EFA)was conducted to identify problematic items and determine ways to enhance the scale’s reliability.Based on the EFA results,two items were dropped.The Swahili version of this new 10-item HIV stigma scale(HSS-10)demonstrated excellent internal consistency with a Cronbach alpha of 0.86(95%confidence interval(CI)0.84-0.89).Confirmatory Factor Analysis indicated that a unidimensional model best fitted the data.The HSS-10 presented a good fit(overall Comparative Fit Index=0.976,Tucker Lewis Index=0.969,Root Mean Square Error of Approximation=0.040,Standardised Root Mean Residual=0.045).Additionally,multi-group CFA indicated measurement invariance across gender and age groups at the strict invariance level asΔCFI was≤0.01.Conclusion:Our findings indicate that the HSS-10 has good psychometric properties and is appropriate for evaluat-ing HIV stigma among perinatally HIV-infected adolescents on the Kenyan coast.Further,study results support the unidimensional model and measurement invariance across gender and age groups of the HSS-10 measure.

Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya

Objective:The purpose of this study was to evaluate the psychometric properties of the World Health Organization’s five item well-being index(WHO-5)when administered to adults living with HIV or epilepsy in a rural setting at the coast of Kenya.Methods:A case control study design was conducted among 230 adults aged 18-50 years,who comprised 147 cases(63 living with epilepsy and 84 living with HIV)and 83 healthy controls.The participants were administered to a faceto-face interview during which they completed the Swahili version of WHO-5 well-being index,the Major Depression Inventory(MDI)and responded to some items on their socio-demographic characteristics.Analysis to assess internal consistency,construct validity,discriminant validity,and convergent validity of the Swahili version of WHO-5 well-being index was conducted.A multivariate regression was carried out to assess the association between psychological wellbeing(assessed using Swahili version of WHO-5 well-being index)and having a chronic illness(HIV or epilepsy).Results:The Swahili version of WHO-5 well-being index demonstrated good internal consistency with Cronbach alpha ranges of 0.86-0.88 among the three study groups.The tool had good discriminant validity.A one factor structure of the tool was obtained from confirmatory factor analysis(overall Comparative Fit Index=1.00,Tuckler Lewis Index=1.01,Root Mean Square of Error Approximation=0.00).Living with HIV or epilepsy in comparison to being a healthy control was significantly associated with greater odds of having sub-optimal psychological wellbeing.Conclusion:Our findings demonstrate that the Swahili version of WHO-5 well-being index has good psychometric properties and is appropriate for use to evaluate psychological well-being among adults living with chronic conditions such as HIV or epilepsy from a rural low resource setting in Kenya.Given its brevity and ease of use,the Swahili version of WHO-5 well-being index could potentially be used by lay workers and other paraprofessional to monitor psychological well-being among chronically ill adults in resource poor settings.