HIV-KQ-18
(18 item version)
HIV-KQ-18
For each statement, please circle True (T), False (F), or I dont know (DK). If you do not know, please
do not guess; instead, please circle DK.
True
False
I dont
know
1.
DK
2.
DK
DK
4.
A woman can get HIV if she has anal sex with a man.
DK
5.
DK
DK
DK
8.
DK
9.
DK
10. A woman cannot get HIV if she has sex during her period.
DK
DK
12. A natural skin condom works better against HIV than does
a latex condom.
DK
DK
14. Having sex with more than one partner can increase a
persons chance of being infected with HIV.
DK
15. Taking a test for HIV one week after having sex will tell a
person if she or he has HIV.
DK
DK
DK
DK
3.
6.
7.
Answer Key
HIV KQ 18
1
TRUE
FALSE
FALSE
TRUE
FALSE
FALSE
FALSE
FALSE
FALSE
10
FALSE
11
TRUE
12
FALSE
13
FALSE
14
TRUE
15
FALSE
16
FALSE
17
TRUE
18
FALSE
Original
1. Coughing and sneezing DO NOT spread
HIV
1.
Spanish Translation
El toser o estornudar NO disemina el contagio de
VIH
4.
4. A woman can get HIV if she has anal sex with a man
5.
6.
7.
8.
9.
10.
10. A woman can not HIV if she has sex during her
menses (period)
12.
13.
14.
15.
16.
17.
18.
Back Translation
1. Coughing or sneezing do not spread HIV
HIV-KQ-45
For each statement, please circle True (T), False (F), or I Dont Know (DK). If you do not know,
please do not guess; instead, please circle DK.
True
False
Dont
Know
DK
DK
DK
DK
DK
DK
DK
8.
DK
9.
DK
10. A pregnant woman with HIV can give the virus to her
unborn baby.
DK
DK
12. A woman can get HIV if she has anal sex with a man.
DK
DK
14. Eating healthy foods can keep a person from getting HIV.
DK
15. All pregnant women infected with HIV will have babies
born with AIDS.
DK
DK
True
False
Dont
Know
DK
18. People who have been infected with HIV quickly show
serious signs of being infected.
DK
DK
20. There is a vaccine that can stop adults from getting HIV.
DK
21. Some drugs have been made for the treatment of AIDS.
DK
22. Women are always tested for HIV during their pap smears.
DK
DK
24. A person can get HIV even if she or he has sex with
another person only one time.
DK
DK
26. People are likely to get HIV by deep kissing, putting their
tongue in their partners mouth, if their partner has HIV.
DK
DK
28. A woman cannot get HIV if she has sex during her period.
DK
29. You can usually tell if someone has HIV by looking at them.
DK
DK
31. A natural skin condom works better against HIV than does
a latex condom.
DK
DK
33. Having sex with more than one partner can increase a
persons chance of being infected with HIV.
DK
True
False
Dont
Know
34. Taking a test for HIV one week after having sex will tell a
person if she or he has HIV.
DK
DK
36. A person can get HIV through contact with saliva, tears,
sweat, or urine.
DK
DK
DK
39. If a person tests positive for HIV, then the test site will
have to tell all of his or her partners.
DK
DK
DK
42. A woman can get HIV if she has vaginal sex with a
man who has HIV.
DK
DK
44. Douching after sex will keep a woman from getting HIV.
DK
DK
FALSE
FALSE
FALSE
TRUE
FALSE
FALSE
FALSE
TRUE
TRUE
10
TRUE
11
FALSE
12
TRUE
13
FALSE
14
FALSE
15
FALSE
16
TRUE
17
TRUE
18
FALSE
19
TRUE
20
FALSE
21
TRUE
22
FALSE
23
FALSE
24
TRUE
25
FALSE
26
FALSE
27
FALSE
28
FALSE
29
FALSE
30
TRUE
31
FALSE
32
FALSE
33
TRUE
34
FALSE
35
FALSE
36
FALSE
37
TRUE
38
TRUE
39
FALSE
40
FALSE
41
FALSE
42
TRUE
43
TRUE
44
FALSE
45
FALSE
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We have developed and evaluated a self-administered questionnaire of knowledge about human immunodeficiency virus (HIV) infection for use in program evaluation. Formative work
led to the development of the 62-item HIV-Knowledge Questionnaire (HIV-K-Q),which was
administered to 409 women and 227 men. Item analyses resulted in the deletion of 17 items
that were either too easy or did not correlate well with the total score. Factor analysis on
the remaining 45 items resulted in a single factor labeled HIV Knowledge. The generalizability
of this one-factor solution was confirmed with data from 285 women and 76 men. Reliability
analyses revealed that the HIV-K-Q is internally consistent (alpha = .91) and stable over
1-week (r = .83), 2-week (r = .91), and 12-week (r = .90) intervals. Evidence for the validity
of the HIV-K-Q was assembled using known groups and treatment outcome analyses. Additional evidence emerged from analyses that revealed associations between scores on the
HTV-K-Q and two related knowledge measures, and between HIV-K-Q scores and level of
educational attainment. Discriminant evidence was obtained through nonsignificant relationships between the HTV-K-Q and potentially biasing constructs, including social desirability.
The HIV-K-Q requires a sixth-grade education, and 7 min to complete. The HIV-K-Q is a
reliable, valid, and practical measure of HIV-related knowledge that can be used with lowliteracy adults.
KEY WORDS: HIV; AIDS; knowledge; measurement; assessment.
tious agent that causes AIDS (Rosenberg, 1995). Although rates of new infections among gay men have
declined, rates among heterosexual men and women
have either remained stable or increased. It has been
estimated that 71% of HIV-infected cases worldwide
involve heterosexual transmission (Ehrhardt, 1992),
and that poverty potentiates the risk of HIV infection
(O'Leary and Jemmott, 1995). AIDS incidence has increased more rapidly in recent years among individuals born in 1960 or later compared to individuals born
earlier (Rosenberg, 1995). These data confirm that
AIDS affects people regardless of their gender, age,
race, or sexual orientation.
Because there is neither a cure nor a vaccine
against HIV and AIDS, behavioral change provides
the only protection against infection. Efforts to prevent or reduce risk of HIV infection through behav-
INTRODUCTION
The Centers for Disease Control and Prevention
recently announced that acquired immunodeficiency
syndrome (AIDS) is the leading cause of death
among young adults in the United States. Estimates
indicate that 3% of African American men and 1%
of African American women in their 30s are living
with human immunodeficiency virus (HIV), the infec-
61
1090-7165/97ABMX)61J12.5(M> O 1997 Plenum Publishing Corporation
62
ior change begin with an understanding of the determinants of risk behavior. Several models have
been proposed to explain HIV-related risk behavior.
Prominent among these are the AIDS Risk Reduction Model (Catania et al., 1990) and the Information-Motivation-Behavioral Skills model (Fisher and
Fisher, 1992). Both models identify knowledge (information) as an important determinant of risk behavior. Accordingly, most intervention programs
provide information about HIV-related transmission
and prevention to help participants to reduce their
risk of infection. In addition, these models invoke
motivational constructs, such as perceived threat or
risk, which require an accurate knowledge of the consequences of HIV infection. To evaluate the validity
of these models and to determine the effectiveness
of interventions guided by them requires a reliable
and valid measure of HIV knowledge.
Several authors have developed measures to assess HIV-related knowledge. Zimet (1992) described
a 22-item measure for adolescents that was based
upon a Centers for Disease Control (1988) brochure.
He reported that the test was internally consistent
(Kuder-Richardson formula 20 coefficient of .77),
but did not provide information on test development
or refinement. Item, factor, or validity analyses were
not conducted (or reported). Koopman et al. (1990)
also developed a measure for adolescents, the AIDS
Knowledge Test (AKT), a 52-item measure of HIVand AIDS-related knowledge. The AKT assesses six
domains (i.e., definitions, outcomes, risk behavior,
transmission, prevention, and HIV testing); however,
no factor analyses have been reported to confirm this
factor structure. Moreover, reliability analyses within
these domains indicated poor internal consistencies
(Cronbach's coefficient alphas ranged from .00 to
.57, M = .43); collapsing across these domains
yielded a more reliable coefficient (alpha = .82) that
was stable (i.e., test-retest reliability of .82 for 1 week
[Koopman et al., 1990]). The validity of the AKT has
not been examined.
Kelly et al. (1989) described the AIDS Risk Behavior Knowledge Test (ARBKT), a standardized 40item measure that they developed for use with gay
men. These authors provided detailed information regarding test construction and development; they also
conducted item, factor, and reliability analyses and attempted to validate the ARBKT by examining pre- (M
= 87%) and post-scores (M = 93%) of 33 men who
underwent an AIDS education seminar. However, the
factor structure of the ARBKT has not been replicated
HIV-Knowledge Questionnaire
63
64
Item
number*
s for
item
Itemtotal^
80.42
91.63
89.09
75.78
97.91
80.87
65.47
64.28
85.35
96.41
18.98
69.81
96.56
94.92
85.20
76.83
90.58
95.07
93.27
66.22
93.27
95.22
59.34
91.18
91.48
29.30
83.41
90.28
81.32
78.62
96.41
46.93
71.30
32.59
94.17
39.61
54.56
62.93
.40
.28
.31
.43
.14
.39
.48
.48
.35
.19
.39
.46
.18
.22
.36
.42
.29
.22
.25
.47
.25
.21
.49
.28
.28
.46
.37
.30
.39
.41
.19
.50
.45
.47
.23
.49
.50
.48
.41
.33
.34
.34
87.89
56.05
81.17
94.02
78.18
58.89
57.10
86.55
80.12
69.51
83.70
54.71
62.78
29.75
.33
.50
.39
.24
.41
.49
.50
.34
.40
.46
.37
.50
.48
.46
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
.17
.31
.35
.33
.29
.26
.32
.40
.35
.45
.29
.45
.34
.34
.21
.12
.40
.22
.48
.48
.42
.33
.37
.34
.15
.32
.13
.40
.32
.25
.38
.42
.39
.12
.34
.45
.49
.35
.41
.42
.36
.27
.07
Item
HIV and AIDS are the same thing
There is a cure for AIDS
A person can get HIV from a toilet seat
Coughing and sneezing DO NOT spread HIV1'
A person can get HIV by sharing an injection needle with someone who has HIV*
A person can get HIV if she or he has sex with someone who shoots up drugs+
HIV can be spread by mosquitoes
AIDS is the cause of HIV
A person can get HIV by sharing a glass of water with someone who has HIV
A person can get HIV by shaking hands with someone who has HIV
HIV is killed by bleach*
It is possible to get HIV when a person gets a tattoof
A man can get HIV if he has sex with another man who has HIV1'
A pregnant woman with HIV can give the virus to her unborn baby+
Pulling out the penis before a man climaxes keeps a woman from getting HIV during sex
A woman can get HIV if she has anal sex with a man*
Showering, or washing one's genitals after sex keeps a person from getting HIV
A man can get HIV if he has vaginal sex with a woman who has HIV*
Eating healthy foods can keep a person from getting HIV
All pregnant women infected with HIV will have babies born with AIDS
Using a latex condom or rubber can lower a person's chance of getting HIV*
Taking the Birth Control Pill keeps a woman from getting HIV
A diaphragm and the Birth Control Pill provide the same protection against HIV infection
Most people with AIDS will die from it*
A person with HIV can look and feel healthy*
There are more cases of AIDS in the USA than in the rest of the world
People who have been infected with HIV quickly show serious signs of being infected
A person can be infected with HIV for 5 years or more without getting AIDS*
There is a vaccine that can stop adults from getting HIV
Some drugs have been made for the treatment of AIDS*
There is a blood test to tell if a person has been infected with HIV*
Women are always tested for HIV during their pap smears
A person cannot get HIV by having oral sex, mouth-to-penis, with a man who has HIV
In the. USA, most cases of AIDS resulted from sex between men and women
A person can get HIV even if she or he has sex with another person only one time*
A mother with HIV can pass it on to her baby by breast feeding*
Using a lambskin condom or rubber is the best protection against HIV
People are likely to get HIV by deep kissing, putting their tongue in their partner's mouth, if
their partner has HIV
Infection with HIV leads to AIDS*
A person can get HIV by giving blood
A woman cannot get HIV if she has sex during her period
You can usually tell if someone has HIV by looking at them
A person can get HIV by getting blood during surgery*
There is a female condom that can help decrease a woman's chance of getting HIV*
A natural skin condom works better against HIV than does a latex condom
A person will NOT get HIV if she or he is taking antibiotics
Having sex with more than one partner can increase a person's chance of being infected with HIV*
Taking a test for HIV 1 week after having sex will tell a person if she or he has HIV
A person can get HIV by sitting in a hot tub or a swimming pool with a person who has HIV
A person can get HIV through contact with saliva, tears, sweat, or urine
A person can get HIV from a woman's vaginal secretions (wetness from her vagina)1'
A person is more likely to get HIV if she or he has another STD (VD), such as herpes or
the clap*
HIV-Knowledge Questionnaire
65
Table I. Continued
Item
number*
Scale Scale Percent
correct
B
A
s for
item
Itemtotal/'
53
21.82
.41
.11
54
18.83
.39
.24
63.53
51.27
79.97
80.57
93.42
89.39
87.59
90.58
.48
.50
.40
.40
.25
.31
.33
.29
.36
.34
.47
.40
.33
.32
.45
.46
55
56
57
58
59
60
61
62
38
39
40
41
42
43
44
45
Item
Taking the AIDS drug AZT lowers the chance of a pregnant woman with HIV giving it to
her baby*
Outside of the USA, most cases of AIDS resulted because of IV (needle) drug use or men
having sex with men
A person can get HIV if having oral sex, mouth on vagina, with a woman*
If a person tests positive for HIV, then the test site will have to tell all of his or her partners
Using Vaseline or baby oil with condoms lowers the chance of getting HIV
Washing drug-use equipment with cold water kills HIV
A woman can get HIV if she has vaginal sex with a man who has HIV*
Athletes who share needles when using steroids can get HIV from the needles*
Douching after sex will keep a woman from getting HIV
Taking vitamins keeps a person from getting HIV
"Items marked with daggers (t) are true, those without are false.
*Items were dropped due either to low item-total correlations or to restriction of range.
Tor total of 56 items remaining after dropping the items with restriction of range (5, 10, 13, 18, 22, and 31) and subtracting the item
to be correlated.
Methods
Participants and Procedures
Participants were recruited from three subsamples (primary care, university, and HIV/AIDS experts) so that we could assemble a diverse sample that
would permit generalization to the general population. Combining the subsamples, participants (N =
669) included 409 women and 227 men (33 subjects
did not identity their gender). Their ages ranged from
15 to 76 years (M = 28.50 years, SD = 12.10). The
sample was diverse with respect to ethnic/racial background (64% European American, 25% African
American, 3% Native American, 3% Hispanic American, 4% Other, 2% did not identity), income (16%
less than $10,000; 16% $10,000-$19,999; 11%
$20,000-30,000; 5% greater than $30,000; 53% did
not report income), and educational level (range =
6-20 years, M = 12.27, SD = 2.36). Demographic
characteristics by subsample are provided in Table II.
Procedures
Means and standard deviations for the 62 HIVK-Q items from the primary care, university students,
and experts (N = 669) were calculated (see Table I).
Examination of the percent correct reveals that six
items were too easy (i.e., Mean >95% correct); these
66
Demographic characteristic
M age in years (s)
Gender
Females
Males
Not specified
Race
European American
African American
Native American
Hispanic American
Other or not specified
M number of children (s)
M education in years (s)
Household income level
Less than $10,000
$10,001-20,000
$20,001-30,000
$30,001-40,000
Greater than $40,000
Unknown
Internal consistency,
45-item HIV-K-Q (a)
M HIV-K-Q proportion
correct (s)
Overall
(N = 1033)
30.59 (11.56)
HIV/AIDS
experts (n = 40)
36.66 (9.38)
Study 3
Primary care
(n = 350)
University
(n = 279)
Couples
(n = 152)
Community
women
(n = 212)
34.99 (12.97)
20.11 (1.95)
34.70 (6.79)
33.85 (11.18)
694 (67%)
303 (29%)
36 (3%)
23 (58%)
16 (40%)
1 (3%)
241 (69%)
87 (25%)
22 (6%)
145 (52%)
124 (44%)
10 (4%)
76 (50%)
76 (50%)
0 (0%)
212 (100%)
0 (0%)
0 (0%)
591 (57%)
329 (32%)
31 (3%)
30 (3%)
52 (5%)
1.99 (1.68)
12.54 (2.40)
19 (48%)
16 (40%)
1 (3%)
1 (3%)
3 (8%)
218 (78%)
29 (10%)
0 (0%)
10 (4%)
22 (8%)
16.46 (2.72)
190 (54%)
119 (34%)
17 (5%)
11 (3%)
13 (4%)
1.92 (1.73)
11.80 (1.78)
141 (93%)
6 (4%)
0 (0%)
0 (0%)
5 (3%)
1.88 (1.52)
14.22 (2.37)
23 (11%)
159 (75%)
13 (13%)
8 (4%)
9 (4%)
2.17 (1.71)
11.82 (1.89)
228 (22%)
165 (16%)
134 (13%)
89 (9%)
60 (6%)
357 (35%)
.91
40 (100%)
.85
104 (30%)
104 (30%)
72 (21%)
30 (9%)
7 (2%)
33 (9%)
.88
.72 (.18)
.91 (.10)
.69 (.17)
279 (100%)
.83
0 (0%)
7 (5%)
45 (30%)
52 (34%)
48 (32%)
0 (0%)
.93
124 (58%)
54 (25%)
17 (8%)
7 (3%)
5 (2%)
3 (1%)
.91
.82 (.12)
.52 (.14)
.72 (.19)
"Due to rounding of individual percentage values, the sum of percentages sometimes differs from 100%.
the primary use of the HIV-K-Q will be for the evaluation of educational and risk reduction programs, it is appropriate to delete items that the vast majority of respondents answer
correctly. This approach allows the generation of a relatively
brief test that results in a more normalized distribution of scores
for the general population. However, this item-analytic approach
may be less appropriate for some clinical applications where the
questionnaire will be used for ideographic assessment purposes
(e.g., to identify high-risk knowledge deficits). Thus, although the
items deleted at this stage of scale development do not add appreciably to the scale for its primary purpose, they remain "critical" knowledge items for clinical use; these items can and should
be used in settings where an assessor needs to be certain that
respondents have the essential knowledge necessary to avoid infection with HIV.
HIV-Knowledge Questionnaire
67
Procedures
All participants completed a self-administered
survey that included the 45-item HIV-K-Q. Procedures for recruitment of participants and composition of the survey varied by sample. The urban
women responded to posted announcements in a variety of community-based settings (e.g., laundromats,
grocery stores, beauty shops, health and social service
clinics, bus stops). The announcements invited
women to participate in a Women's Health Project
to be held at an urban community-based organization. Women completed the survey in small groups,
and were paid $15. The couples responded to newspaper announcements requesting participants in a
study of marital communication. One male and one
female member of the research team visited couples
in their homes, and supervised the independent completion of the survey. Each couple was paid $20 for
their participation.
Results
STUDY 4. RELIABILITY
68
acteristics for the entire sample and for each subsample can be found in Table II.
Analyses of the test-retest stability made use of
data from two sources. First, a subset of the urban
women's sample ( = 33) completed the HIV-K-Q
on three occasions; the first occasion as described in
Study 3, and then again at 2-week and 12-week retest
sessions. Second, a subset of the university students
also completed the HIV-K-Q on two occasions, separated by approximately one week. Procedures for the
retest sessions were identical to those used for the
initial data collection.
Results
Internal Consistency
Internal consistency was determined with Cronbach's (1951) alpha. Alpha for the total sample (N
= 1,033) was .91, which reflects a high degree of internal consistency. Alpha was also calculated separately for each subsample, and ranged from .83 to
.93 across the five subsamples.
Test-Retest Stability
A Pearson product-moment correlation coefficient was calculated for the urban women who took
the HIV-K-Q on three occasions, with 2-week and
3-month retest intervals ( = 33 and n = 25, respectively). These calculations indicated high
test-retest reliability (r = .91 and r = .90 at 2 and
12 weeks, respectively; both ps < .0001). The
test-retest correlation for the university students
was r(130) = .83, p < . 0001.
HIV-Knowledge Questionnaire
The women completed the HIV-K-Q independently 1
week before and 1 week after the program.
Results
Scores on the HIV-K-Q indicated that women
assigned to the intervention condition significantly
unproved their scores from pre- (M = 75%) to postintervention (M = 87%) assessments, f(42) = 6.08,
p = .0001, d = 0.90. In contrast, women in the control condition of this study did not improve their
scores, M = 71% and M = 72%, respectively, f(31)
= 0.79, p > .10, d = 0.13.
69
70
The purpose of Study 8 was to assemble convergent evidence for the validity of the HIV-K-Q.
Convergent evidence obtains when the measure being validated correlates with other measures that are
designed to assess the same or related constructs
(Kazdin, 1995; Campbell and Fiske, 1959). We anticipated strong, positive associations between scores
on the HIV-K-Q and two extant measures of HIVrelated knowledge. However, because such correlations between self-administered questionnaires may
also occur as a result of shared method variance
(Kazdin, 1995), we also examined the association between HIV-knowledge scores and level of educational attainment. Prior research (Peruga and
Celentano, 1993) suggested a positive association between these two variables, which is what we expected
to find.
Knowledge Test, and a demographic survey in a waiting room as they waited to be seen.
The AIDS Risk Behavior Knowledge Test
(ARBKT; Kelly et al., 1989) is a 40-item measure of
AIDS risk behavior knowledge. The ARBKT has
been judged to be internally consistent (KR-20 =
.74) and stable (i.e., test-retest r = .84 over 2 weeks
[Kelly et al., 1989]).
The AIDS Knowledge Test (AKT; Koopman et al.,
1990) is a 52-item measure of HIV- and AIDS-related
knowledge. The AKT has been judged to be internally
consistent (i.e., Cronbach's alpha = .82) and stable
(i.e., test-retest r = .82 over 1 week [Koopman et al.,
1990]).
These two measures were selected as the best
available similar measures of HIV-related knowledge.
As we noted in the Introduction, these measures
have proven useful with the populations for whom
they were developed, but they may be less appropriate for low-literacy adult men and women.
Results
Methods
HIV-Knowledge Questionnaire
Methods
The instructions and all 45 items of the HFV-KQ were entered in a text file and split into passages
of approximately 100 words each. For purposes of
readability analysis, HIV AIDS, and Vaseline were
treated as proper names. Two formulas, the Flesch
and the Spache, were used to determine the readability of the material. These readability formulas use
common features of words and passages (e.g.,
number of syllables, number of words, number of
sentences) to measure the difficulty of the material.
Results
Analysis of the 45-item HTV-K-Q with the Flesch
formula indicated that the material was at the primary-grade level, with most passages in the "fairly
easy" to "Very easy" range. Analysis using the Spache
formula revealed that the majority of the material
was below 4th-grade level. However, several "foreign" words increased the level to approximately the
7th-grade level; these "foreign" words include vaccine, antibiotics, genitals, and pap smears, that is,
words that are either medical or sexual in nature. Although these words increase the reading level, they
are likely to be understood by low-literacy readers
due to their common use in the popular culture.
71
clinic. Participants were administered the HIV-K-Q
individually in a waiting room. They were instructed
to answer each question carefully and, when finished,
to return this survey and request the next one. A research assistant privately recorded the time required
to complete the HIV-K-Q. Respondents were not
told that they were being timed.
College Sample
Participants were 28 female and 21 male undergraduates (M age = 18.63 years, SD = 0.88) from
the same university population that was sampled for
Study 2. Participants expected to participate in a series of studies on "Social Attitudes" and were seated
in individual cubicles that precluded visual contact
with any other participant. Each cubicle contained a
computer through which all instructions and questions were administered. After a brief introduction
to the computer, the questionnaire was introduced
without participants' foreknowledge. Participants
were simply instructed that they should "answer the
following true-false items about HIV and AIDS."
Respondents were not told that their responses were
being timed. Each question from the 45-item HIVK-Q was then presented individually, with a unique
random order of items for each participant. Participants pressed the "a" key for a "True" response, "b"
for a "False" response, and "c" for a "Don't Know"
response. The computer recorded latencies to respond to each question.
Results
Community respondents' mean proportion of
correct answers to the HIV-K-Q was .74 (SD = .14),
which does not differ significantly from the mean for
the earlier primary care sample (M = .69), F(l,
398) = 2.95, p = .0869. It took an average of 6.98
min (SD = 2.19) to complete the HIV-K-Q, with
times ranging from 3.50 to 12.00 min. The correlation
between time to complete the HIV-K-Q and the
score attained on it was moderate in magnitude,
r(45) = -0.29, p = .0536.
College student respondents' mean proportion of
correct answers to theHlV-K-Qwas .85 (SD = .07),
which does not differ from the mean for the earlier
university sample (M = .82), F (1,326) = 3.17, p =
.0762. It took an average of 4.12 min (SD = 0.77) to
complete the HIV-K-Q, ranging from 1.37 to 5.85
72
min. The time to complete the HIV-K-Q was unrelated to the score attained on it, r (48) = .02. The
mean time to respond to any given item ranged from
a low of 2.73 sec (for item 2 on Scale B, see Table I)
to a high of 10.28 sec (for item 41).
DISCUSSION
The purpose of this study was to develop and
evaluate the psychometric properties of the HIVKnowledge Questionnaire. Formative research
guided the generation of a 62-item scale that assessed knowledge about the transmission, prevention,
and consequences of HIV infection. Item analyses indicated that 17 of the 62 items should be deleted because of item ease or poor association with the total
scale. Many of the items deleted can be considered
"critical items," that is, items containing essential
public health knowledge regarding HIV transmission
and prevention. These items describe risk associated
with needle-sharing, men who have sex with men,
and heterosexual vaginal sex (Scale A, items 5, 13,
and 18, respectively). It is comforting to know that
more than 95% of our sample answered these items
correctly, and it is appropriate to delete such items
for our purposes (i.e., program evaluation). However,
these items may prove useful in certain clinical settings where idiographic assessment of high-risk individuals is necessary; knowledge of such material
should never be assumed in clinical and counseling
settings with an individual client.
Principal factor analyses of the remaining 45
items suggested that a single-factor could account for
a significant amount of the variance; this single-factor
solution was replicated in a cross-validation sample.
Thus, these analyses demonstrate that the HIV-K-Q is
a unidimensional instrument that measures HlV-related knowledge. Reliability analyses indicated that the
HIV-K-Q is internally consistent and stable over intervals as long as 3 months. Validity analyses revealed, as
expected, that the HIV-K-Q is not associated with
other constructs, including social desirability, negative
or positive mood, self-esteem, depression, dyadic adjustment, sexual satisfaction, or attitudes toward condoms. As expected, however, the HIV-K-Q is
associated with level of educational attainment, with
better educated respondents scoring higher on the
HIV-K-Q (Peruga and Celentano, 1993).
An additional source of validity evidence was provided by the association between the HIV-K-Q and
HIV-Knowledge Questionnaire
ACKNOWLEDGMENTS
73
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