Comprehensive knowledge of HIV among women in rural Mozambique: development and validation of the HIV knowledge 27 scale.

Ciampa PJ, Skinner SL, Patricio SR, Rothman RL, Vermund SH, Audet CM
PLoS One. 2012 7 (10): e48676

PMID: 23119087 · PMCID: PMC3485372 · DOI:10.1371/journal.pone.0048676

BACKGROUND - The relationship between HIV knowledge and HIV-related behaviors in settings like Mozambique has been limited by a lack of rigorously validated measures.

METHODS - A convenience sample of women seeking prenatal care at two clinics were administered an adapted, orally-administered, 27 item HIV-knowledge scale, the HK-27. Validation analyses were stratified by survey language (Portuguese and Echuabo). Kuder-Richardson (KR-20) coefficients estimated internal reliability. Construct validity was assessed with bivariate associations between HK-27 scores (% correct) and selected participant characteristics. The association between knowledge, self-reported HIV testing, and HIV infection were evaluated with multivariable logistic regression.

RESULTS - Participants (N = 348) had a median age of 24; 188 spoke Portuguese, and 160 spoke Echuabo. Mean HK-27 scores were higher for Portuguese-speaking participants than Echuabo-speaking participants (68% correct vs. 42%, p<0.001). Internal reliability was strong (KR-20>0.8) for scales in both languages. Higher HK-27 scores were significantly (p≤0.05) correlated with more education, more media items in the home, a history of HIV testing, and participant work outside of the home for women of both languages. HK-27 scores were independently associated with completion of HIV testing in multivariable analysis (per 1% correct: aOR:1.02, 95%CI:0.01-0.03, p = 0.01), but not with HIV infection.

CONCLUSIONS - HK-27 is a reliable and valid measure of HIV knowledge among Portuguese and Echuabo-speaking Mozambican women. The HK-27 demonstrated significant knowledge deficits among women in the study, and higher scores were associated with higher HIV testing probability. Future studies should evaluate the role of the HK-27 in longitudinal studies and in other populations.

MeSH Terms (16)

Adult Educational Status Female Health Knowledge, Attitudes, Practice HIV Infections Humans Language Logistic Models Mozambique Multivariate Analysis Pregnancy Prenatal Care Reproducibility of Results Rural Population Surveys and Questionnaires Young Adult

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