Objective To revise human immunodeficiency virus (HIV) Treatment Adherence Self-Efficacy Scale-Chinese Version (HIV-ASES) and to evaluate its reliability and validity for providing an instrument to follow-up studies on the medication compliance of patients with HIV/acquired immunodeficiency syndrome (AIDS) in China.
Methods The HIV-ASES-Chinese Version was revised with an expert consultation and modified based on Chinese culture background. Then the revised HIV-ASES-Chinese Version was administered among 1 215 HIV/AIDS patients (whom were registered in Henan Provincial Center for Disease Control and Prevention and under highly active antiroviral therapy HAART) selected with stratified multistage cluster random sampling in 6 regions of Henan province (Shangcai, Shenqiu, Queshan, Yongcheng, Jiyuan and Sanmenxia) from July 2015 to July 2016 to evaluate therapeutic compliance of patients and to assess the rationality of the theoretical structure of the revised HIV-ASES-Chinese Version based on project analysis. The reliability and validity of the scale were also assessed simultaneously.
Results In comparison with the original scale, one item was excluded and a new item was added to the the HIV-ASES-Chinese Version and the revised scale was consisted of two domains, namely integration (6 entries) and perseverance (6 entries). The results of the project analysis resulted in the correlation coefficients between the 12 entries and the total score of the HIV-ASES-Chinese Version ranging from 0.572 to 0.758 (all P < 0.001), suggesting the scale is of good item discrimination. The overall Cronbach α coefficient, retest reliability and split-half reliability of the revised scale were 0.930, 0.807, and 0.858; the Cronbach α coefficient and test-retest reliability are 0.912 and 0.775 for the integration domain and 0.867 and 0.720 for the perseverance domain, respectively, suggesting a good reliability of the scale. The results of exploratory factor analysis revealed that the cumulative variance contribution of the 2 public factors of the HIV-ASES-Chinese Version was 63.642%, and the structure of the factors belonging to each item is basically the same as that of the original scale. The confirmatory factor analysis on the HIV-ASES-Chinese Version resulted in a comparative goodness of fit index (CFI) of 0.966, an approximate error mean square root (RMSEA) of 0.079, a goodness of fit index (GFI) of 0.944, an adjusted goodness of fit index (AGFI) of 0.905, a root mean square residual value (RMR) of 0.114, and a standardized root mean square residual (SRMR) of 0.033. For all the participants, the overall scores of the HIV-ASES-Chinese Version, the Morisky Questionnaire and the Social Support Rating Scale (SSRS) were 127.32 ± 18.36, 14.58 ± 2.00 and 34.35 ± 1.62; the self-reported medication compliance rate during past one month and one week were 86.5% and 90.7%, respectively. The overall score of the HIV-ASES-Chinese Version was significantly correlated with the overall scores of Morisky Questionnaire and SSRS and with the self-reported medication compliance rate during past one month and one week, with the correlation coefficients of 0.450, 0.261, 0.288, and 0.321 (P < 0.01 for all), indicating a good criterion validity of the revised scale.
Conclusion The reliability and validity of the revised HIV-ASES-Chinese Version meet the requirements of psychometrics and could be used to evaluate medication compliance among HIV/AIDS patients in China.
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