Development of a treatment optimism scale for HIV-positive gay and bisexual men

Potential items to be included in an HIV Treatment Optimism scale were reviewed by 17 HIV-positive gay and bisexual men (GBM), resulting in a 21-item test instrument. After pilot testing, data were collected from a multi-city sample of high-risk HIV-positive GBM (n=346), who were currently on treatment and were recruited to attend a two-day sexual health seminar. The scale items were analyzed utilizing Principal Components Analysis and reliability testing. The factor analysis resulted in the development of three separate scales. The Susceptibility scale contained 10 items associated with a belief that HIV is less transmissible while on HIV treatment. The Condom Motivation scale contained five items addressing a decreased motivation to use condoms while on treatment and the Severity scale contained four items associated with a decreased sense of the severity of an HIV diagnosis. Reliability coefficients (alpha) and mean inter-item correlations (M) for the three scales were acceptable (Susceptibility, alpha = 0.86, M=0.39; Condom Motivation, alpha = 0.84, M = 0.50; Severity, alpha = 0.71, M=0.37). Combined as one scale,the reliability coefficient was respectable (alpha = 0.76), but the mean inter-item correlation was 0.14. Based on this analysis, use of a single measure was not supported and three separate scales were developed. The scales were equivalent across racial groups except White men were more like to report a decreased motivation to use condoms compared to Black or Latino men. Three separate scales addressing beliefs about the transmissibility of HIV while on treatment (Susceptibility), the quality of life while on HIV treatment (Severity) and the motivation to use condoms consistently while on treatment (Condom Motivation) may be better markers for assessing optimistic beliefs about HIV treatment among HIV-positive GBM.