Psychometric properties of the Chinese version of the WHOQOL-HIV BREF to assess quality of life among people living with HIV/AIDS: a cross-sectional study

OBJECTIVES This study aims to assess the psychometric properties of the Chinese version of the WHOQOL-HIV BREF. DESIGN Cross-sectional study. SETTING Centers for Disease Control and Prevention and infectious disease hospitals in three Chinese provinces. PARTICIPANTS Sample of 1100 people living with HIV/AIDS (PLWHA). INTERVENTIONS We recruited 1100 PLWHA to evaluate their quality of life (QOL) using the WHOQOL-HIV BREF. Of these participants, 57 were randomly selected to repeat the QOL evaluation 2 weeks later. MAIN OUTCOME MEASURES The reliability of the WHOQOL-HIV BREF was assessed in terms of its internal consistency and test-retest reliability. The construct, concurrent, convergent, discriminant and known-group validity were also analysed. In addition, the factorial invariance across genders was assessed. RESULTS Cronbach's α coefficient for the overall scale was 0.93. Except for the spirituality domain, which had an α below 0.70 (0.66), the other five domains showed adequate internal consistency. The test-retest reliability revealed a statistically significant intraclass correlation coefficient of 0.72-0.82 (p<0.001). Confirmatory factor analysis found that the six-domain structure produced an acceptable fit to the data. The instrument showed factorial invariance across gender groups. All domains were significantly correlated with the general items and the SF-36 (p<0.01). The correlation coefficients were >0.40 (r=0.40-0.67), except for the association between the spirituality domain and two general items (QOL: r=0.33; health status: r=0.36). Subjects with lower CD4 counts had lower scores for all domains (p<0.05). Symptomatic participants had significantly lower scores than asymptomatic participants on the physical, psychological and independence domains (p<0.05). CONCLUSIONS The WHOQOL-HIV BREF revealed good psychometric characteristics among Chinese PLWHA. These findings offer promising support for the use of the WHOQOL-HIV BREF as a measure of QOL among Chinese PLWHA and in cross-cultural comparative studies on QOL.