Reliability and construct validity of three health-related self-report scales in HIV-positive adults in rural Rwanda

AIDS Care. 2012;24(12):1576-83. doi: 10.1080/09540121.2012.661840. Epub 2012 Mar 19.


Depression, low health-related quality of life, and low perceived social support have been shown to predict poor health outcomes, including HIV-related outcomes. Mental health morbidity and HIV are important public health concerns in Rwanda, where approximately half of the current population is estimated to have survived the genocide and 3% is living with HIV. We examined the reliability and construct validity of the Hopkins Symptom Checklist-15 (HSCL-15), the Medical Outcomes Study HIV Health Survey (MOS-HIV), and the Duke/UNC Functional Social Support Questionnaire (DUFSSQ), which were used to assess depression, health-related quality of life, and perceived social support, respectively, among HIV-infected adults in rural Rwanda. We also studied whether scale reliability differed by gender, literacy status, or antiretroviral therapy (ART) delivery strategy. The Kinyarwanda versions of the HSCL-15, MOS-HIV, and DUFSSQ performed well in the study population. Reliability was favorable (Cronbach's alpha coefficients ≥0.75 or above) for the scales overall and across subgroups of gender, literacy, and mode of ART delivery. The scales also demonstrated good convergent, discriminant, and known-group validity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Retroviral Agents / therapeutic use
  • Depression / diagnosis*
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / psychology*
  • Health Status Indicators*
  • Health Surveys
  • Humans
  • Interviews as Topic
  • Male
  • Predictive Value of Tests
  • Principal Component Analysis
  • Psychiatric Status Rating Scales
  • Psychometrics / methods
  • Psychometrics / statistics & numerical data
  • Quality of Life*
  • Reproducibility of Results
  • Rural Population
  • Rwanda
  • Self Report
  • Severity of Illness Index
  • Sex Factors
  • Social Support*
  • Socioeconomic Factors
  • Surveys and Questionnaires / standards*


  • Anti-Retroviral Agents