Background
Barriers to HIV testing
experienced by individuals at risk for HIV can result in treatment delay and
further transmission of the disease. Instruments to systematically measure
barriers are scarce, but could contribute to improved strategies for HIV
testing. Aims of this study were to develop and test a barriers to HIV testing scale
in a Swedish context.
Methods
An 18-item scale was
developed, based on an existing scale with addition of six new items related to
fear of the disease or negative consequences of being diagnosed as
HIV-infected. Items were phrased as statements about potential barriers with a
three-point response format representing not important, somewhat important, and
very important. The scale was evaluated regarding missing values, floor and
ceiling effects, exploratory factor analysis, and internal consistencies.
Results
The questionnaire was
completed by 292 adults recently diagnosed with HIV infection, of whom 7 were
excluded (≥9 items missing) and 285 were included (≥12 items completed) in the
analyses. The participants were 18–70 years old (mean 40.5, SD 11.5), 39 %
were females and 77 % born outside Sweden. Routes of transmission were
heterosexual transmission 63 %, male to male sex 20 %, intravenous
drug use 5 %, blood product/transfusion 2 %, and unknown 9 %.
All scale items had <3 % missing values. The data was feasible for
factor analysis (KMO = 0.92) and a four-factor solution was chosen, based on
level of explained common variance (58.64 %) and interpretability of
factor structure. The factors were interpreted as; personal consequences, structural barriers, social and economic security,
and confidentiality.
Ratings on the minimum level (suggested barrier not important) were common,
resulting in substantial floor effects on the scales. The scales were
internally consistent (Cronbach’s α 0.78–0.91).
Conclusions
This study gives
preliminary evidence of the scale being feasible, reliable and valid to
identify different types of barriers to HIV testing.
Full article at:
Department of
Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm,
Sweden
Department of
Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
Department of
Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
Department of
Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
Department of
Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm,
Sweden
School of Health
Sciences, City University London, London, UK
Division of
Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska
Institutet, 23300, SE-141 83 Huddinge, Sweden
Maria Wiklander, Phone: + 46 707 27 10 13, Email: es.ik@rednalkiw.airam.
More at: https://twitter.com/hiv_insight
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