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The WHOMEN’s Scale (Women’s HAART Optimism Monitoring and EvaluatioN Scale v.1) and the Association with Fertility Intentions and Sexual Behaviours Among HIV-Positive Women in Uganda

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Abstract

The objective of this study was to develop a reliable HAART optimism scale among HIV-positive women in Uganda and to test the scale’s validity against measures of fertility intentions, sexual activity, and unprotected sexual intercourse. We used cross-sectional survey data of 540 women (18–50 years) attending Mbarara University’s HIV clinic in Uganda. Women were asked how much they agreed or disagreed with 23 statements about HAART. Data were subjected to a principal components and factor analyses. Subsequently, we tested the association between the scale and fertility intentions and sexual behaviour using Wilcoxon rank sum test. Factor analysis yielded three factors, one of which was an eight-item HAART optimism scale with moderately high internal consistency (α = 0.70). Women who reported that they intended to have (more) children had significantly higher HAART optimism scores (median = 13.5 [IQR: 12–16]) than women who did not intend to have (more) children (median = 10.5 [IQR: 8–12]; P < 0.0001). Similarly, women who were sexually active and who reported practicing unprotected sexual intercourse had significantly higher HAART optimism scores than women who were sexually abstinent or who practiced protected sexual intercourse. Our reliable and valid scale, termed the Women’s HAART Optimism Monitoring and EvaluatioN scale (WHOMEN’s scale), may be valuable to broader studies investigating the role of HAART optimism on reproductive intentions and sexual behaviours of HIV-positive women in high HIV prevalence settings.

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Acknowledgments

This research was supported by the National Institutes of Health (NIMH 54907). David R. Bangsberg received support from the National Institute on Alcohol Abuse and Alcoholism (NIAAA 015287). Angela Kaida is supported by the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research. We would like to thank the research and clinical staff and clients at the Mbarara Regional Referral Hospital Immune Suppression Syndrome Clinic.

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Authors and Affiliations

  1. BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, Canada

    Angela Kaida, Viviane Dias Lima & Robert S. Hogg

  2. School of Population and Public Health, University of British Columbia (UBC), Vancouver, BC, Canada

    Angela Kaida

  3. Mbarara University of Science and Technology (MUST), Mbarara, Uganda

    Irene Andia, Jerome Kabakyenga & Pamela Mbabazi

  4. University of California, San Francisco (UCSF), San Francisco, CA, USA

    Nneka Emenyonu

  5. University of California, San Diego (UCSD), San Diego, CA, USA

    Thomas L. Patterson

  6. Simon Fraser University (SFU), Burnaby, BC, Canada

    Robert S. Hogg

  7. Harvard Medical School/MGH, Boston, MA, USA

    David R. Bangsberg

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  1. Angela Kaida
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  2. Viviane Dias Lima
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  3. Irene Andia
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  9. David R. Bangsberg
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Correspondence to Angela Kaida.

Appendix 1

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Table 4 Complete list of statements included in the questionnaire
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Kaida, A., Lima, V.D., Andia, I. et al. The WHOMEN’s Scale (Women’s HAART Optimism Monitoring and EvaluatioN Scale v.1) and the Association with Fertility Intentions and Sexual Behaviours Among HIV-Positive Women in Uganda. AIDS Behav 13 (Suppl 1), 72–81 (2009). https://doi.org/10.1007/s10461-009-9553-y

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