上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (10): 1351-1358.doi: 10.3969/j.issn.1674-8115.2021.10.013
石大可1,2(), 王甦平1(
), 龚睿婕1, 倪阳3(
), 蔡泳1(
)
出版日期:
2021-10-28
发布日期:
2021-09-22
通讯作者:
倪阳,蔡泳
E-mail:dake_shi@126.com;niyanghj@163.com;caiyong202028@hotmail.com
作者简介:
石大可 (1990—),男,主治医师,学士;电子信箱:dake_shi@126.com基金资助:
Da-ke SHI1,2(), Su-ping WANG1(
), Rui-jie GONG1, Yang NI3(
), Yong CAI1(
)
Online:
2021-10-28
Published:
2021-09-22
Contact:
Yang NI,Yong CAI
E-mail:dake_shi@126.com;niyanghj@163.com;caiyong202028@hotmail.com
Supported by:
摘要:
目的·引入艾滋病病毒相关知识问卷(Brief HIV Knowledge Questionnaire,HIV-KQ-18),评价该问卷在艾滋病病毒阴性的性传播疾病(sexually transmitted diseases,STD)人群中测量的信度和效度,并根据其知识得分预测该人群的性行为。方法·将HIV-KQ-18汉化后,对2018年1月至2018年12月于上海市皮肤病医院门诊就诊的符合条件的599名STD患者进行评测,将其随机分成2部分,一部分(n=300)进行探索性因子分析,另一部分(n=299)进行验证性因子分析;将发生性行为时始终使用安全套判定为安全性行为并作为因变量,HIV-KQ-18得分作为自变量,作受试者工作特征曲线,评估问卷对安全性行为的预测能力及临界值。结果·探索性因子分析显示,该问卷可提取3个因子即艾滋病的传播(7个条目)、有效的预防措施(4个条目)和感染艾滋病的后果(3个条目);从HIV-KQ-18剔除4个条目,形成中文版HIV-KQ-14。验证性因子分析显示,三因子修正模型拟合情况优良(χ2/df=2.046,近似误差的平方根=0.059,增值适配指数=0.926,Tucker-Lewis指数=0.908,比较拟合指数=0.925)。问卷的Cronbach′s α系数为0.861,Spearman-Brown系数为0.815。问卷得分预测安全性行为曲线下面积为0.708(P=0.000)。结论·中文版HIV-KQ-14在HIV阴性STD患者中有良好的信效度,对安全性行为有较好的预测能力。
中图分类号:
石大可, 王甦平, 龚睿婕, 倪阳, 蔡泳. 中文版艾滋病病毒相关知识问卷在艾滋病病毒阴性的性传播疾病人群中的信效度评价[J]. 上海交通大学学报(医学版), 2021, 41(10): 1351-1358.
Da-ke SHI, Su-ping WANG, Rui-jie GONG, Yang NI, Yong CAI. Reliability and validity evaluation of Chinese version of Brief HIV Knowledge Questionnaire for HIV-negative sexually transmitted diseases patients[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(10): 1351-1358.
Item | Total |
---|---|
Gender/n(%) | |
Male | 263 (43.9) |
Female | 336 (56.1) |
Age/n(%) | |
≤25 year | 81 (13.5) |
26‒40 year | 348 (58.1) |
41‒60 year | 148 (24.7) |
≥61 year | 22 (3.7) |
Education/n(%) | |
College degree and above | 341 (56.9) |
High school (including secondary school and vocational school) | 135 (22.5) |
Junior high school | 104 (17.4) |
Elementary school and below | 19 (3.2) |
Marriage/n(%) | |
Unmarried | 171 (28.5) |
Married | 390 (65.1) |
Divorced | 28 (4.7) |
Widowed | 10 (1.7) |
Income level/n(%) | |
≤3 000 yuan | 67 (11.2) |
3001‒ 6 000 yuan | 206 (34.4) |
6001‒12 000 yuan | 176 (29.4) |
≥12 001 yuan | 150 (25.0) |
Sexual orientation/n(%) | |
Heterosexuality | 553 (92.3) |
Minority sexual orientation | 46 (7.7) |
Frequency of condom use/n(%) | |
Use condoms every time | 190 (31.7) |
Intermittent use of condoms or no condoms | 409 (68.3) |
表1 STD患者的人口学信息(n=599)
Tab 1 Demographic characteristics of STD patients (n=599)
Item | Total |
---|---|
Gender/n(%) | |
Male | 263 (43.9) |
Female | 336 (56.1) |
Age/n(%) | |
≤25 year | 81 (13.5) |
26‒40 year | 348 (58.1) |
41‒60 year | 148 (24.7) |
≥61 year | 22 (3.7) |
Education/n(%) | |
College degree and above | 341 (56.9) |
High school (including secondary school and vocational school) | 135 (22.5) |
Junior high school | 104 (17.4) |
Elementary school and below | 19 (3.2) |
Marriage/n(%) | |
Unmarried | 171 (28.5) |
Married | 390 (65.1) |
Divorced | 28 (4.7) |
Widowed | 10 (1.7) |
Income level/n(%) | |
≤3 000 yuan | 67 (11.2) |
3001‒ 6 000 yuan | 206 (34.4) |
6001‒12 000 yuan | 176 (29.4) |
≥12 001 yuan | 150 (25.0) |
Sexual orientation/n(%) | |
Heterosexuality | 553 (92.3) |
Minority sexual orientation | 46 (7.7) |
Frequency of condom use/n(%) | |
Use condoms every time | 190 (31.7) |
Intermittent use of condoms or no condoms | 409 (68.3) |
Item No. | Content | r value |
---|---|---|
1 | 咳嗽和打喷嚏不会传播艾滋病病毒 (Coughing and sneezing do not spread HIV) | 0.470 |
2 | 与艾滋病病毒感染者共饮一杯水会被感染艾滋病病毒 (A person can get HIV by sharing a glass of water with someone who has HIV) | 0.373 |
3 | 在射精前拔出性器官能避免伴侣感染艾滋病病毒 (Pulling out the penis before a man climaxes/cums keeps a partner from getting HIV during sex) | 0.516 |
4 | 与感染艾滋病病毒的男性发生肛门性交会感染艾滋病病毒 (Someone can get HIV if he/she has anal sex with a man) | 0.473 |
5 | 性交后清洗生殖器官能避免感染艾滋病病毒 (Showering, or washing one's genital after sex keeps a person from getting HIV) | 0.608 |
6 | 艾滋病病毒阳性的孕妇必定会产下有艾滋病的婴儿 (All pregnant women infected with HIV will have babies born with AIDS) | 0.492 |
7 | 感染了艾滋病病毒的人很快就会出现严重的感染症状 (People who have been infected with HIV quickly show serious signs of being infected) | 0.638 |
8 | 现在有预防艾滋病病毒感染的疫苗 (There is a vaccine that can stop adults from getting HIV) | 0.571 |
9 | 与感染艾滋病病毒的伴侣深接吻、舌吻可能会感染艾滋病 (People are likely to get HIV by deep kissing, and putting their tongue in their partner’s mouth, if their partner has HIV) | 0.383 |
10 | 女性在月经期性交不会感染艾滋病病毒 (A woman cannot get HIV if she has sex during her period) | 0.623 |
11 | 现在有女性避孕套可以降低女性感染艾滋病的机会 (There is a female condom that can help decrease a woman's chance of getting HIV) | 0.333 |
12 | 正确和一贯使用安全套能降低艾滋病感染风险 (Correct and consistent use of condoms can reduce the risk of HIV infection) | 0.514 |
13 | 正在服用抗生素的人能够避免感染艾滋病病毒 (A person will not get HIV if she or he is taking antibiotics) | 0.691 |
14 | 与多人发生性关系会增加感染艾滋病的机会 (Having sex with more than one partner can increase a person’s chance of being infected with HIV) | 0.431 |
15 | 性交后1周后进行检测能确认是否感染艾滋病病毒 (Taking a test for HIV one week after having sex will tell a person if she or he has HIV) | 0.583 |
16 | 与艾滋病病毒感染者共浴或共享泳池会感染艾滋病病毒 (A person can get HIV by sitting in a hot tub or a swimming pool with a person who has HIV) | 0.559 |
17 | 艾滋病病毒可以通过口腔性交传播 (A person can get HIV from oral sex) | 0.216 |
18 | 在安全套上涂凡士林或婴儿油能降低感染艾滋病病毒风险 (Using Vaseline or baby oil with condoms lowers the chance of getting HIV) | 0.554 |
表2 HIV-KQ-18中文版各条目相关系数(n=300)
Tab 2 Correlation coefficients of items in the Chinese version of HIV-KQ-18 (n=300)
Item No. | Content | r value |
---|---|---|
1 | 咳嗽和打喷嚏不会传播艾滋病病毒 (Coughing and sneezing do not spread HIV) | 0.470 |
2 | 与艾滋病病毒感染者共饮一杯水会被感染艾滋病病毒 (A person can get HIV by sharing a glass of water with someone who has HIV) | 0.373 |
3 | 在射精前拔出性器官能避免伴侣感染艾滋病病毒 (Pulling out the penis before a man climaxes/cums keeps a partner from getting HIV during sex) | 0.516 |
4 | 与感染艾滋病病毒的男性发生肛门性交会感染艾滋病病毒 (Someone can get HIV if he/she has anal sex with a man) | 0.473 |
5 | 性交后清洗生殖器官能避免感染艾滋病病毒 (Showering, or washing one's genital after sex keeps a person from getting HIV) | 0.608 |
6 | 艾滋病病毒阳性的孕妇必定会产下有艾滋病的婴儿 (All pregnant women infected with HIV will have babies born with AIDS) | 0.492 |
7 | 感染了艾滋病病毒的人很快就会出现严重的感染症状 (People who have been infected with HIV quickly show serious signs of being infected) | 0.638 |
8 | 现在有预防艾滋病病毒感染的疫苗 (There is a vaccine that can stop adults from getting HIV) | 0.571 |
9 | 与感染艾滋病病毒的伴侣深接吻、舌吻可能会感染艾滋病 (People are likely to get HIV by deep kissing, and putting their tongue in their partner’s mouth, if their partner has HIV) | 0.383 |
10 | 女性在月经期性交不会感染艾滋病病毒 (A woman cannot get HIV if she has sex during her period) | 0.623 |
11 | 现在有女性避孕套可以降低女性感染艾滋病的机会 (There is a female condom that can help decrease a woman's chance of getting HIV) | 0.333 |
12 | 正确和一贯使用安全套能降低艾滋病感染风险 (Correct and consistent use of condoms can reduce the risk of HIV infection) | 0.514 |
13 | 正在服用抗生素的人能够避免感染艾滋病病毒 (A person will not get HIV if she or he is taking antibiotics) | 0.691 |
14 | 与多人发生性关系会增加感染艾滋病的机会 (Having sex with more than one partner can increase a person’s chance of being infected with HIV) | 0.431 |
15 | 性交后1周后进行检测能确认是否感染艾滋病病毒 (Taking a test for HIV one week after having sex will tell a person if she or he has HIV) | 0.583 |
16 | 与艾滋病病毒感染者共浴或共享泳池会感染艾滋病病毒 (A person can get HIV by sitting in a hot tub or a swimming pool with a person who has HIV) | 0.559 |
17 | 艾滋病病毒可以通过口腔性交传播 (A person can get HIV from oral sex) | 0.216 |
18 | 在安全套上涂凡士林或婴儿油能降低感染艾滋病病毒风险 (Using Vaseline or baby oil with condoms lowers the chance of getting HIV) | 0.554 |
Item | Factor 1 | Factor 2 | Factor 3 | Item | Factor 1 | Factor 2 | Factor 3 |
---|---|---|---|---|---|---|---|
Item 13 | 0.735 | -0.016 | -0.097 | Item 2 | 0.239 | 0.194 | 0.163 |
Item 5 | 0.719 | -0.123 | -0.172 | Item 17 | 0.217 | -0.136 | -0.171 |
Item 10 | 0.699 | -0.124 | -0.208 | Item 7 | 0.068 | 0.653 | -0.136 |
Item 3 | 0.635 | 0.003 | -0.110 | Item 8 | 0.096 | 0.550 | -0.240 |
Item 18 | 0.578 | -0.100 | -0.317 | Item 15 | 0.320 | 0.487 | -0.345 |
Item 14 | 0.576 | -0.405 | 0.279 | Item 6 | 0.311 | 0.415 | -0.158 |
Item 4 | 0.561 | -0.238 | 0.087 | Item 12 | 0.489 | -0.196 | 0.609 |
Item 11 | 0.396 | -0.325 | 0.336 | Item 1 | 0.315 | 0.117 | 0.501 |
Item 9 | 0.314 | 0.269 | 0.119 | Item 16 | 0.169 | 0.357 | 0.490 |
表3 HIV-KQ-18中文版的条目负荷(n=300)
Tab 3 Results of exploratory factor of the Chinese version of HIV-KQ-18 (n=300)
Item | Factor 1 | Factor 2 | Factor 3 | Item | Factor 1 | Factor 2 | Factor 3 |
---|---|---|---|---|---|---|---|
Item 13 | 0.735 | -0.016 | -0.097 | Item 2 | 0.239 | 0.194 | 0.163 |
Item 5 | 0.719 | -0.123 | -0.172 | Item 17 | 0.217 | -0.136 | -0.171 |
Item 10 | 0.699 | -0.124 | -0.208 | Item 7 | 0.068 | 0.653 | -0.136 |
Item 3 | 0.635 | 0.003 | -0.110 | Item 8 | 0.096 | 0.550 | -0.240 |
Item 18 | 0.578 | -0.100 | -0.317 | Item 15 | 0.320 | 0.487 | -0.345 |
Item 14 | 0.576 | -0.405 | 0.279 | Item 6 | 0.311 | 0.415 | -0.158 |
Item 4 | 0.561 | -0.238 | 0.087 | Item 12 | 0.489 | -0.196 | 0.609 |
Item 11 | 0.396 | -0.325 | 0.336 | Item 1 | 0.315 | 0.117 | 0.501 |
Item 9 | 0.314 | 0.269 | 0.119 | Item 16 | 0.169 | 0.357 | 0.490 |
Item | Factor 1 | Factor 2 | Factor 3 |
---|---|---|---|
Item 10 | 0.744 | 0.284 | 0.027 |
Item 5 | 0.720 | 0.254 | 0.174 |
Item 14 | 0.633 | -0.195 | 0.480 |
Item 4 | 0.614 | 0.001 | 0.236 |
Item 13 | 0.584 | 0.368 | 0.283 |
Item 3 | 0.553 | 0.302 | 0.196 |
Item 18 | 0.549 | 0.371 | 0.004 |
Item 15 | 0.104 | 0.774 | 0.026 |
Item 8 | 0.336 | 0.541 | 0.075 |
Item 6 | 0.121 | 0.538 | 0.125 |
Item 7 | 0.365 | 0.514 | 0.293 |
Item 12 | 0.348 | 0.052 | 0.679 |
Item 1 | 0.174 | 0.138 | 0.669 |
Item 16 | -0.061 | 0.487 | 0.623 |
表4 Spearson相关系数法优化后HIV-KQ-14中文版的条目负荷(n=300)
Tab 4 Results of exploratory factor of the Chinese version of HIV-KQ-14 optimized by correlation coefficients (n=300)
Item | Factor 1 | Factor 2 | Factor 3 |
---|---|---|---|
Item 10 | 0.744 | 0.284 | 0.027 |
Item 5 | 0.720 | 0.254 | 0.174 |
Item 14 | 0.633 | -0.195 | 0.480 |
Item 4 | 0.614 | 0.001 | 0.236 |
Item 13 | 0.584 | 0.368 | 0.283 |
Item 3 | 0.553 | 0.302 | 0.196 |
Item 18 | 0.549 | 0.371 | 0.004 |
Item 15 | 0.104 | 0.774 | 0.026 |
Item 8 | 0.336 | 0.541 | 0.075 |
Item 6 | 0.121 | 0.538 | 0.125 |
Item 7 | 0.365 | 0.514 | 0.293 |
Item 12 | 0.348 | 0.052 | 0.679 |
Item 1 | 0.174 | 0.138 | 0.669 |
Item 16 | -0.061 | 0.487 | 0.623 |
Dimension | Item | Loading |
---|---|---|
Transmission Knowledge of HIV | Item 3 | 0.641 |
Item 4 | 0.641 | |
Item 5 | 0.594 | |
Item 10 | 0.665 | |
Item 13 | 0.640 | |
Item 14 | 0.580 | |
Item 18 | 0.620 | |
Consequences of being infected with HIV | Item 6 | 0.532 |
Item 7 | 0.674 | |
Item 8 | 0.593 | |
Item 15 | 0.552 | |
Preventive measures of HIV | Item 1 | 0.457 |
Item 12 | 0.599 | |
Item 16 | 0.522 |
表5 三因子修正模型的因子负荷(n=299)
Tab 5 Factor loading of three-factor model of the Chinese version of HIV-KQ-14 (n=299)
Dimension | Item | Loading |
---|---|---|
Transmission Knowledge of HIV | Item 3 | 0.641 |
Item 4 | 0.641 | |
Item 5 | 0.594 | |
Item 10 | 0.665 | |
Item 13 | 0.640 | |
Item 14 | 0.580 | |
Item 18 | 0.620 | |
Consequences of being infected with HIV | Item 6 | 0.532 |
Item 7 | 0.674 | |
Item 8 | 0.593 | |
Item 15 | 0.552 | |
Preventive measures of HIV | Item 1 | 0.457 |
Item 12 | 0.599 | |
Item 16 | 0.522 |
Dimension | Item | CVI | |
---|---|---|---|
I-CVI | S-CVI/Ave | ||
Transmission Knowledge of HIV | Item 3 | 1.00 | 0.97 |
Item 4 | 1.00 | ||
Item 5 | 1.00 | ||
Item 10 | 1.00 | ||
Item 13 | 0.78 | ||
Item 14 | 1.00 | ||
Item 18 | 1.00 | ||
Consequences of being infected with HIV | Item 6 | 1.00 | 0.97 |
Item 7 | 1.00 | ||
Item 8 | 0.89 | ||
Item 15 | 1.00 | ||
Preventive measures of HIV | Item 1 | 0.89 | 0.93 |
Item 12 | 1.00 | ||
Item 16 | 0.89 |
表6 HIV-KQ-14中文版各维度以及条目水平的内容效度指数
Tab 6 Content validity index of each dimension and item level of the Chinese version of HIV-KQ-14
Dimension | Item | CVI | |
---|---|---|---|
I-CVI | S-CVI/Ave | ||
Transmission Knowledge of HIV | Item 3 | 1.00 | 0.97 |
Item 4 | 1.00 | ||
Item 5 | 1.00 | ||
Item 10 | 1.00 | ||
Item 13 | 0.78 | ||
Item 14 | 1.00 | ||
Item 18 | 1.00 | ||
Consequences of being infected with HIV | Item 6 | 1.00 | 0.97 |
Item 7 | 1.00 | ||
Item 8 | 0.89 | ||
Item 15 | 1.00 | ||
Preventive measures of HIV | Item 1 | 0.89 | 0.93 |
Item 12 | 1.00 | ||
Item 16 | 0.89 |
Dimension | Transmission Knowledge of HIV | Consequences of being infected with HIV | Preventive measures of HIV |
---|---|---|---|
Transmission Knowledge of HIV | 0.627 | ‒ | ‒ |
Consequences of being infected with HIV | 0.546 | 0.560 | ‒ |
Preventive measures of HIV | 0.445 | 0.473 | 0.558 |
表7 各因子区分效度
Tab 7 Discriminant validity of the three factors
Dimension | Transmission Knowledge of HIV | Consequences of being infected with HIV | Preventive measures of HIV |
---|---|---|---|
Transmission Knowledge of HIV | 0.627 | ‒ | ‒ |
Consequences of being infected with HIV | 0.546 | 0.560 | ‒ |
Preventive measures of HIV | 0.445 | 0.473 | 0.558 |
Chinese version of HIV-KQ | AUC | P value | 95%CI | Cut-off value | Yorden index | Sensitivity/% | Specificity/% |
---|---|---|---|---|---|---|---|
HIV-KQ-18 | 0.639 | 0.000 | 0.594‒0.685 | 9.5 | 0.225 | 89.5 | 33.0 |
HIV-KQ-14 | 0.708 | 0.000 | 0.665‒0.751 | 9.5 | 0.384 | 79.5 | 58.9 |
表8 HIV-KQ-18和HIV-KQ-14预测安全性行为的临界值(n=599)
Tab 8 Predictive ability for safe sex of the Chinese version of HIV-KQ-18 and HIV-KQ-14 (n=599)
Chinese version of HIV-KQ | AUC | P value | 95%CI | Cut-off value | Yorden index | Sensitivity/% | Specificity/% |
---|---|---|---|---|---|---|---|
HIV-KQ-18 | 0.639 | 0.000 | 0.594‒0.685 | 9.5 | 0.225 | 89.5 | 33.0 |
HIV-KQ-14 | 0.708 | 0.000 | 0.665‒0.751 | 9.5 | 0.384 | 79.5 | 58.9 |
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