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Psychometric testing of the consequences of an HIV disclosure instrument in Mandarin: a cross-sectional study of persons living with HIV in Hunan, China

Authors Xiao X, Zhao J, Tang C, Li X, Simoni JM, Wang H, Fennie KP

Received 18 March 2018

Accepted for publication 25 May 2018

Published 17 August 2018 Volume 2018:12 Pages 1451—1459


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Naifeng Liu

Xueling Xiao,1 Junshi Zhao,2 Chulei Tang,1 Xianhong Li,1 Jane M Simoni,3 Honghong Wang,1 Kristopher P Fennie4

1Xiangya School of Nursing, Central South University, Changsha, People’s Republic of China; 2Department of STD/AIDS, Center for Disease Control and Prevention of Hunan Province, Changsha, People’s Republic of China; 3Department of Psychology, University of Washington, Seattle, WA, USA; 4Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA

Purpose: This study aimed to examine the psychometric properties of a Mandarin-language version of an instrument that assesses the Consequences of HIV Disclosure (CoHD).
Patients and methods: The original CoHD instrument developed by Serovich was translated into Mandarin and administered to a random sample of 184 persons living with HIV (PLWH) using face-to-face and structured interviews. The CoHD instrument required respondents to rate the importance of eight costs (eg, might lose the relationship) and ten rewards (eg, would bring us closer) in their decision about whether to self-disclose their HIV status. The participants were directed to respond with respect to a current (or hypothetical) sexual partner.
Results: Internal consistency was acceptable (Cronbach’s α for the overall scale 0.82, costs 0.71, and rewards 0.86), as was stability (test–retest reliability overall 0.74, cost 0.63, and rewards 0.82). The CVI for the scale was 0.83, with items rated by subject experts ranging from 0.80 to 1.0. To determine structural validity, exploratory factor analysis extracted two subscales consistent with the original CoHD subscales. The Mandarin CoHD scores were significantly correlated with disclosure self-efficacy (indicating convergent validity), but they were unrelated to safer sex efficacy (indicating divergent validity). This criterion was tested by comparing the scores of PLWH who disclosed their HIV status (mean±SD 53.57±9.06) with those who did not disclose it (mean±SD 49.63±7.45); however, the difference was not statistically significant.
Conclusion: The Mandarin version of the CoHD instrument demonstrates promising psychometric properties when assessing costs and rewards with respect to sexual partner disclosure. This suggests that it might be useful in research on partner notification strategies. In further studies, larger and more diverse samples and an analysis of responses for different disclosure targets are warranted. Moreover, whether the CoHD score is related to the decision of disclosure should be determined.

Keywords: HIV, self-disclosure, sexual partner, partner notification, psychometric analysis, China

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