Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Research article

Validating survey measurement scales for AIDS-related knowledge and stigma among construction workers in South Africa

Authors: Paul Bowen, Rajen Govender, Peter Edwards

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Construction workers in South Africa are regarded as a high-risk group in the context of HIV/AIDS. HIV testing is pivotal to controlling HIV transmission and providing palliative care and AIDS-related knowledge and stigma are key issues in addressing the likelihood of testing behaviour. In exploring these issues, various studies have employed an 11-item AIDS-related knowledge scale (Kalichman and Simbayi, AIDS Care 16:572-580, 2004) and a 9-item stigma scale (Kalichman et al., AIDS Behav 9:135-143, 2005), but little evidence exists confirming the psychometric properties of these scales.

Methods

Using survey data from 512 construction workers in the Western Cape, South Africa, this research examines the validity and reliability of the two scales through exploratory and confirmatory factor analysis and internal consistency tests.

Results

From confirmatory factor analysis, a revised 10-item knowledge scale was developed (χ2 /df ratio = 1.675, CFI = 0.982, RMSEA = 0.038, and Hoelter (95 %) =393). A revised 8-item stigma scale was also developed (χ2 /df ratio = 1.929, CFI = 0.974, RMSEA = 0.045, and Hoelter (95 %) = 380). Both revised scales demonstrated good model fit and all factor loadings were significant (p < 0.01). Reliability analysis demonstrated excellent to good internal consistency, with alpha values of 0.80 and 0.74, respectively. Both revised scales also demonstrated satisfactory convergent and divergent validity. Limitations of the original survey from which the data was obtained include the failure to properly account for respondent selection of language for completion of the survey, use of ethnicity as a proxy for identifying the native language of participants, the limited geographical area from which the survey data was collected, and the limitations associated with the convenience sample. A limitation of the validation study was the lack of available data for a more robust examination of reliability beyond internal consistency, such as test-retest reliability.

Conclusions

The revised knowledge and stigma scales offered here hold considerable promise as measures of AIDS-related knowledge and stigma among South African construction workers.
Literature
1.
go back to reference Stats SA. P0277 Quarterly Employment Statistics June 2015. Pretoria: Statistics South Africa; 2015. Stats SA. P0277 Quarterly Employment Statistics June 2015. Pretoria: Statistics South Africa; 2015.
2.
go back to reference Stats SA. P0211 Quarterly Labour Force Survey 4th Quarter 2014. Pretoria: Statistics South Africa; 2014. Stats SA. P0211 Quarterly Labour Force Survey 4th Quarter 2014. Pretoria: Statistics South Africa; 2014.
3.
go back to reference Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African National HIV Prevalence, Incidence and Behaviour Survey. 2012. Cape Town: HSRC Press; 2014. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African National HIV Prevalence, Incidence and Behaviour Survey. 2012. Cape Town: HSRC Press; 2014.
4.
go back to reference Ambert C. Economic impact of HIV/AIDS on the construction sector: Supply side implications for housing policy. S Afr J Econ. 2002;70:1235–61.CrossRef Ambert C. Economic impact of HIV/AIDS on the construction sector: Supply side implications for housing policy. S Afr J Econ. 2002;70:1235–61.CrossRef
5.
go back to reference Bureau for Economic Research (BER). The Economic Impact of HIV/AIDS on Business in South Africa, 2003. Stellenbosch: Bureau for Economic Research; 2004. Bureau for Economic Research (BER). The Economic Impact of HIV/AIDS on Business in South Africa, 2003. Stellenbosch: Bureau for Economic Research; 2004.
6.
go back to reference Harinarain N, Haupt TC. Drivers for the effective management of HIV and AIDS in the South African construction industry - a Delphi study. Journal of AIDS Research. 2014;13:291–303.CrossRef Harinarain N, Haupt TC. Drivers for the effective management of HIV and AIDS in the South African construction industry - a Delphi study. Journal of AIDS Research. 2014;13:291–303.CrossRef
7.
go back to reference Bowen PA, Dorrington R, Distiller G, Lake H, Besesar S. HIV/AIDS in the South African construction industry: an empirical study. Constr Manag Econ. 2008;26:827–39.CrossRef Bowen PA, Dorrington R, Distiller G, Lake H, Besesar S. HIV/AIDS in the South African construction industry: an empirical study. Constr Manag Econ. 2008;26:827–39.CrossRef
8.
go back to reference Chartered Institute of Building (CIOB). SACPCMP notes: the challenges of a united construction industry. Contact Africa. 2004;3:6. Chartered Institute of Building (CIOB). SACPCMP notes: the challenges of a united construction industry. Contact Africa. 2004;3:6.
9.
go back to reference International Organization for Migration (IOM). Regional assessment on HIV-prevention needs of migrants and mobile populations in Southern Africa, Construction Sector Report. Pretoria: International Organization for Migration; 2010. International Organization for Migration (IOM). Regional assessment on HIV-prevention needs of migrants and mobile populations in Southern Africa, Construction Sector Report. Pretoria: International Organization for Migration; 2010.
10.
go back to reference Johnson L, Budlender D. HIV risk factors: A review of the demographic, socio-economic, biomedical and behavioural determinants of HIV prevalence in South Africa. CARE Monograph No. 8. Cape Town: Centre for Actuarial Research, University of Cape Town; 2002. Johnson L, Budlender D. HIV risk factors: A review of the demographic, socio-economic, biomedical and behavioural determinants of HIV prevalence in South Africa. CARE Monograph No. 8. Cape Town: Centre for Actuarial Research, University of Cape Town; 2002.
11.
go back to reference Bowen P, Edwards P, Simbayi L, Cattell K. HIV/AIDS interventions by construction firms in the Western Cape, South Africa: A thematic analysis of qualitative survey data. Int J Constr Manag. 2013;13(4):11–33. Bowen P, Edwards P, Simbayi L, Cattell K. HIV/AIDS interventions by construction firms in the Western Cape, South Africa: A thematic analysis of qualitative survey data. Int J Constr Manag. 2013;13(4):11–33.
12.
go back to reference Bowen P, Allen Y, Edwards P, Cattell K, Simbayi L. Guidelines for effective HIV/AIDS intervention management by construction firms. Constr Manag Econ. 2014;32:362–81.CrossRef Bowen P, Allen Y, Edwards P, Cattell K, Simbayi L. Guidelines for effective HIV/AIDS intervention management by construction firms. Constr Manag Econ. 2014;32:362–81.CrossRef
13.
go back to reference Meintjes I, Bowen PA, Root D. HIV/AIDS in the South African construction industry: understanding the HIV/AIDS discourse for a sector specific response. Constr Manag Econ. 2007;25:255–66.CrossRef Meintjes I, Bowen PA, Root D. HIV/AIDS in the South African construction industry: understanding the HIV/AIDS discourse for a sector specific response. Constr Manag Econ. 2007;25:255–66.CrossRef
14.
go back to reference Denison JA, O’Reilly KR, Schmid GP, Kennedy CE, Sweat MD. HIV voluntary counseling and testing and behavioral risk reduction in developing countries: a meta-analysis, 1990–2005. AIDS Behav. 2008;12:363–73.CrossRefPubMed Denison JA, O’Reilly KR, Schmid GP, Kennedy CE, Sweat MD. HIV voluntary counseling and testing and behavioral risk reduction in developing countries: a meta-analysis, 1990–2005. AIDS Behav. 2008;12:363–73.CrossRefPubMed
15.
go back to reference Yahaya LA, Jimoh AAG, Balogun OR. Factors hindering acceptance of HIV/AIDS Voluntary Counseling and Testing (VCT) among youth in Kwara State, Nigeria. Afr J Reprod Health. 2010;14:159–64.PubMed Yahaya LA, Jimoh AAG, Balogun OR. Factors hindering acceptance of HIV/AIDS Voluntary Counseling and Testing (VCT) among youth in Kwara State, Nigeria. Afr J Reprod Health. 2010;14:159–64.PubMed
16.
go back to reference Kaufman MR, Massey M, Tsang SW, Kamala B, Serlemitsos E, Lyles E, et al. An assessment of HIV testing in Tanzania to inform future strategies and interventions. AIDS Care. 2014; 10.1080/09540121.2014.963007. Kaufman MR, Massey M, Tsang SW, Kamala B, Serlemitsos E, Lyles E, et al. An assessment of HIV testing in Tanzania to inform future strategies and interventions. AIDS Care. 2014; 10.1080/09540121.2014.963007.
17.
go back to reference MacPhail C, Pettifor A, Moyo W, Rees H. Factors associated with HIV testing among sexually active South African youth aged 15–24 years. AIDS Care. 2009;21:456–67.CrossRefPubMed MacPhail C, Pettifor A, Moyo W, Rees H. Factors associated with HIV testing among sexually active South African youth aged 15–24 years. AIDS Care. 2009;21:456–67.CrossRefPubMed
18.
go back to reference Abiodun O, Sotunsa J, Franklin A, Jaiyesimi E. Knowledge of HIV/AIDS and predictors of uptake of HIV counseling and testing among undergraduate students of a privately owned university in Nigeria. BMC Res Notes. 2014;7:639. Available at: http://www.biomedcentral.com/1756-0500/7/639 [accessed 20th February 2015].CrossRefPubMedPubMedCentral Abiodun O, Sotunsa J, Franklin A, Jaiyesimi E. Knowledge of HIV/AIDS and predictors of uptake of HIV counseling and testing among undergraduate students of a privately owned university in Nigeria. BMC Res Notes. 2014;7:639. Available at: http://​www.​biomedcentral.​com/​1756-0500/​7/​639 [accessed 20th February 2015].CrossRefPubMedPubMedCentral
19.
go back to reference Klein SJ, Karchner WJ, O’Connell DA. Interventions to prevent HIV-related stigma and discrimination. J Public Health Manag Pract. 2002;8:44–53.CrossRefPubMed Klein SJ, Karchner WJ, O’Connell DA. Interventions to prevent HIV-related stigma and discrimination. J Public Health Manag Pract. 2002;8:44–53.CrossRefPubMed
20.
go back to reference Mahajan AP, Sayles JN, Patel VA, Remien RH, Sawires SR, Ortiz DJ, et al. Stigma in the HIV⁄AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22 Suppl 2:s67–79.CrossRefPubMedPubMedCentral Mahajan AP, Sayles JN, Patel VA, Remien RH, Sawires SR, Ortiz DJ, et al. Stigma in the HIV⁄AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS. 2008;22 Suppl 2:s67–79.CrossRefPubMedPubMedCentral
21.
go back to reference Deacon H, Uys L, Mohlahlane R. HIV and Stigma in South Africa. In: Rohleder P, Swartz L, Kalichman SC, Simbayi LC, editors. HIV/AIDS in South Africa 25 Years On: Psychological Perspectives. New York: Springer; 2009. p. 105–20. Chapter 8.CrossRef Deacon H, Uys L, Mohlahlane R. HIV and Stigma in South Africa. In: Rohleder P, Swartz L, Kalichman SC, Simbayi LC, editors. HIV/AIDS in South Africa 25 Years On: Psychological Perspectives. New York: Springer; 2009. p. 105–20. Chapter 8.CrossRef
22.
go back to reference Feyissa GT, Abebe L, Girma E, Woldie M. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia. BMC Public Health. 2012;12:522.CrossRefPubMedPubMedCentral Feyissa GT, Abebe L, Girma E, Woldie M. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia. BMC Public Health. 2012;12:522.CrossRefPubMedPubMedCentral
23.
go back to reference Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9:135–43.CrossRefPubMed Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9:135–43.CrossRefPubMed
24.
go back to reference Nyblade L, MacQuarrie K. Can we measure HIV/AIDS-related stigma and discrimination: Current knowledge about quantifying stigma in developing countries. Report, United States Agency for International Development (USAID). 2006: January, 21pp. Nyblade L, MacQuarrie K. Can we measure HIV/AIDS-related stigma and discrimination: Current knowledge about quantifying stigma in developing countries. Report, United States Agency for International Development (USAID). 2006: January, 21pp.
25.
go back to reference Siyam’kela Project. Siyam’kela: measuring HIV/AIDS related stigma - HIV/AIDS stigma indicators. Cape Town: Policy project, Centre for the Study of AIDS. South Africa: USAID and the Department of Health; 2003. Siyam’kela Project. Siyam’kela: measuring HIV/AIDS related stigma - HIV/AIDS stigma indicators. Cape Town: Policy project, Centre for the Study of AIDS. South Africa: USAID and the Department of Health; 2003.
26.
go back to reference Maughan-Brown B. Measuring HIV/AIDS Stigma (CSSR Working Paper No. 74). Cape Town: Centre for Social Science Research; 2004. Maughan-Brown B. Measuring HIV/AIDS Stigma (CSSR Working Paper No. 74). Cape Town: Centre for Social Science Research; 2004.
27.
go back to reference Holzemer WL, Uys LR, Chirwa ML, Greeff M, Makoae LN, Kohi TW, et al. Validation of the HIV/AIDS stigma instrument – PLWA (HASI-P). AIDS Care. 2007;19:1002–12.CrossRefPubMed Holzemer WL, Uys LR, Chirwa ML, Greeff M, Makoae LN, Kohi TW, et al. Validation of the HIV/AIDS stigma instrument – PLWA (HASI-P). AIDS Care. 2007;19:1002–12.CrossRefPubMed
28.
go back to reference Uys LR, Holzemer WL, Chirwa ML, Dlamini PS, Greeff M, Kohi TW, et al. The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N). AIDS Care. 2009;21:150–9.CrossRefPubMedPubMedCentral Uys LR, Holzemer WL, Chirwa ML, Dlamini PS, Greeff M, Kohi TW, et al. The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N). AIDS Care. 2009;21:150–9.CrossRefPubMedPubMedCentral
29.
go back to reference Kalichman SC, Simbayi LC. Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care. 2004;16:572–80.CrossRefPubMed Kalichman SC, Simbayi LC. Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care. 2004;16:572–80.CrossRefPubMed
30.
go back to reference Pitpitan EV, Kalichman SC, Eaton LA, Cain D, Sikkema KJ, Skinner D, et al. AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape Town. Ann Behav Med. 2012;43:362–71.CrossRefPubMedPubMedCentral Pitpitan EV, Kalichman SC, Eaton LA, Cain D, Sikkema KJ, Skinner D, et al. AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape Town. Ann Behav Med. 2012;43:362–71.CrossRefPubMedPubMedCentral
31.
go back to reference Scott-Sheldon LAJ, Carey MP, Carey KB, Cain D, Simbayi LC, Mehlomakhulu V, et al. HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town, South Africa. Afr J AIDS Res. 2013;12:195–201.CrossRefPubMedPubMedCentral Scott-Sheldon LAJ, Carey MP, Carey KB, Cain D, Simbayi LC, Mehlomakhulu V, et al. HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town, South Africa. Afr J AIDS Res. 2013;12:195–201.CrossRefPubMedPubMedCentral
32.
go back to reference Bowen PA, Govender R, Edwards PJ, Cattell KS. An integrated model of HIV/AIDS testing behaviour in the construction industry. Constr Manag Econ. 2014;32:1106–29.CrossRef Bowen PA, Govender R, Edwards PJ, Cattell KS. An integrated model of HIV/AIDS testing behaviour in the construction industry. Constr Manag Econ. 2014;32:1106–29.CrossRef
33.
go back to reference Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV knowledge questionnaire (NIV-KQ-18). AIDS Educ Prev. 2002;14:174–84.CrossRef Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV knowledge questionnaire (NIV-KQ-18). AIDS Educ Prev. 2002;14:174–84.CrossRef
34.
go back to reference Carey MP, Morrison-Beedy D, Johnson BT. The HIV-Knowledge Questionnaire: Development and Evaluation of a Reliable, Valid, and Practical Self-Administered Questionnaire. AIDS Behav. 1979;1:61–74.CrossRef Carey MP, Morrison-Beedy D, Johnson BT. The HIV-Knowledge Questionnaire: Development and Evaluation of a Reliable, Valid, and Practical Self-Administered Questionnaire. AIDS Behav. 1979;1:61–74.CrossRef
35.
go back to reference Pequegnat W, Bauman LJ, Bray J, DiClemente R, DiIorio C, Hoppe S, et al. Measurement of the role of families in prevention and adaptation to HIV/AIDS. AIDS Behav. 2001;5:1–19.CrossRef Pequegnat W, Bauman LJ, Bray J, DiClemente R, DiIorio C, Hoppe S, et al. Measurement of the role of families in prevention and adaptation to HIV/AIDS. AIDS Behav. 2001;5:1–19.CrossRef
36.
go back to reference Bauman LJ, Camacho S, Silver E, Hudis J, Draimin B. Behavioral problems in school-aged children of mothers with HIV/AIDS. Clin Child Psychol Psychiatry. 2002;7:39–54.CrossRef Bauman LJ, Camacho S, Silver E, Hudis J, Draimin B. Behavioral problems in school-aged children of mothers with HIV/AIDS. Clin Child Psychol Psychiatry. 2002;7:39–54.CrossRef
37.
go back to reference Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. Am J Public Health. 2002;92:371–7.CrossRefPubMedPubMedCentral Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. Am J Public Health. 2002;92:371–7.CrossRefPubMedPubMedCentral
38.
go back to reference Kalichman SC, Simbayi LC. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sex Transm Infect. 2003;79:442–7.CrossRefPubMedPubMedCentral Kalichman SC, Simbayi LC. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sex Transm Infect. 2003;79:442–7.CrossRefPubMedPubMedCentral
39.
go back to reference Widaman KF, Grimm KJ. Advanced psychometrics: Confirmatory factor analysis, item response theory, and the study of measurement invariance. In: Reis HT, Judd CM, editors. Handbook of research methods in social and personality psychology. 2nd ed. New York: Cambridge University Press; 2014. p. 534–70. Widaman KF, Grimm KJ. Advanced psychometrics: Confirmatory factor analysis, item response theory, and the study of measurement invariance. In: Reis HT, Judd CM, editors. Handbook of research methods in social and personality psychology. 2nd ed. New York: Cambridge University Press; 2014. p. 534–70.
40.
go back to reference Pett MA, Lackey NR, Sullivan JJ. Making Sense of Factor Analysis: The Use of Factor Analysis for Instrument Development in Health Care Research. Thousand Oaks: Sage; 2003.CrossRef Pett MA, Lackey NR, Sullivan JJ. Making Sense of Factor Analysis: The Use of Factor Analysis for Instrument Development in Health Care Research. Thousand Oaks: Sage; 2003.CrossRef
41.
go back to reference Brown TA. Confirmatory Factor Analysis for Applied Research. New York: The Guildford Press; 2006. Brown TA. Confirmatory Factor Analysis for Applied Research. New York: The Guildford Press; 2006.
42.
go back to reference Corporation IBM. IBM SPSS Statistics for Macintosh, Version 22.0. Armonk: BM Corp; 2013. Corporation IBM. IBM SPSS Statistics for Macintosh, Version 22.0. Armonk: BM Corp; 2013.
43.
go back to reference Pallant J. SPSS Survival Manual. 4th ed. Maidenhead: Open University Press, McGraw-Hill Education; 2010. Pallant J. SPSS Survival Manual. 4th ed. Maidenhead: Open University Press, McGraw-Hill Education; 2010.
44.
go back to reference Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39:31–6.CrossRef Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39:31–6.CrossRef
45.
go back to reference Catell RB. The scree test for the number of factors. Multivar Behav Res. 1966;1:245–76.CrossRef Catell RB. The scree test for the number of factors. Multivar Behav Res. 1966;1:245–76.CrossRef
46.
go back to reference Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30:179–85.CrossRefPubMed Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30:179–85.CrossRefPubMed
47.
go back to reference Watkins MW. Monte Carlo PCA for Parallel Analysis [computer software]. State College, PA, Ed & Psych Associates. 2000 Watkins MW. Monte Carlo PCA for Parallel Analysis [computer software]. State College, PA, Ed & Psych Associates. 2000
48.
go back to reference Corporation IBM. IBM AMOS for Windows, Version 22.0. Armonk: IBM Corp; 2013. Corporation IBM. IBM AMOS for Windows, Version 22.0. Armonk: IBM Corp; 2013.
49.
go back to reference Kline RB. Principles and Practice of Structural Equation Modeling. 3rd ed. New York: The Guildford Press; 2011. Kline RB. Principles and Practice of Structural Equation Modeling. 3rd ed. New York: The Guildford Press; 2011.
50.
go back to reference Byrne B. Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. 2nd ed. New York: Taylor and Francis; 2010. Byrne B. Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. 2nd ed. New York: Taylor and Francis; 2010.
51.
go back to reference Tabachnick GG, Fidell LS. Using Multivariate Statistics. 5th ed. Boston: Pearson Education; 2013. Tabachnick GG, Fidell LS. Using Multivariate Statistics. 5th ed. Boston: Pearson Education; 2013.
Metadata
Title
Validating survey measurement scales for AIDS-related knowledge and stigma among construction workers in South Africa
Authors
Paul Bowen
Rajen Govender
Peter Edwards
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2756-z

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue