Kane Jeremy C, Bolton Paul, Murray Sarah M, Bass Judith K, Lakin Daniel, Whetten Kathryn, Skavenski van Wyk Stephanie, Murray Laura K
a Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA.
b Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA.
AIDS Care. 2018 Feb;30(2):160-167. doi: 10.1080/09540121.2017.1384787. Epub 2017 Oct 11.
Social desirability bias and underreporting of HIV risk behaviors are significant challenges to the accurate evaluation of HIV prevention programs for orphans and vulnerable children (OVC) in sub-Saharan Africa. Valid and reliable HIV risk behavior instruments are critical to address these challenges. We assessed the psychometric properties of two risk behavior measures, the World Aids Foundation Survey (WAF) and the Peer HIV Risk Behavior Screener (PHRBS), administered to 210 OVC in Zambia using Audio Computer Assisted Self-Interviewing. All WAF subscales exhibited good internal reliability (α > .80); only the Sexual Behavior Practices subscale strongly distinguished (P < .01) adolescents who engaged in HIV risk behaviors ("cases") from those who did not ("non-cases"). An 8-item version of the PHRBS, refined using exploratory factor analysis, demonstrated good internal reliability (α = 87), differentiated "cases" from "non-cases" (P < .01), and correlated strongly with the Sexual Behavior Practices subcale (r = .34, P < .01). Results suggest that report of peers' sexual behaviors can serve as a proxy for OVCs' own behavior in contexts where social desirability bias affects reporting.
社会期望偏差以及对艾滋病毒风险行为的漏报，是准确评估撒哈拉以南非洲地区孤儿和弱势儿童（OVC）艾滋病毒预防项目面临的重大挑战。有效且可靠的艾滋病毒风险行为评估工具对于应对这些挑战至关重要。我们使用音频计算机辅助自我访谈，对赞比亚的210名孤儿和弱势儿童施测了两种风险行为测量工具，即世界艾滋病基金会调查（WAF）和同伴艾滋病毒风险行为筛查工具（PHRBS），并评估了它们的心理测量特性。WAF的所有子量表都表现出良好的内部信度（α>.80）；只有性行为实践子量表能显著区分（P<.01）有艾滋病毒风险行为的青少年（“病例”）和没有此类行为的青少年（“非病例”）。通过探索性因素分析优化后的8项版PHRBS表现出良好的内部信度（α = 0.87），能区分“病例”和“非病例”（P<.01），并与性行为实践子量表高度相关（r = 0.34，P<.01）。结果表明，在社会期望偏差影响报告的情况下，同伴性行为报告可作为孤儿和弱势儿童自身行为的替代指标。
