Human Immunodeficiency Virus type 1 (HIV-1) infection is a chronic disease that affects ~40 million people worldwide. HIV-associated neurocognitive disorders (HAND) are common in individuals with HIV-1 Infection, and represent a recent public health problem. Here we evaluate the performance of a recently proposed short protocol for detecting HAND by studying 60 individuals with HIV-1-Infection and 60 seronegative controls from a Caribbean community in Barranquilla, Colombia. The short evaluation protocol used significant neuropsychological tests from a previous study of asymptomatic HIV-1 infected patients and a group of seronegative controls. Brief screening instruments, i.e., the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS), were also applied. Using machine-learning techniques, we derived predictive models of HAND status, and evaluated their performance with the ROC curves. The proposed short protocol performs exceptionally well yielding sensitivity, specificity, and overall prediction values >90%, and better predictive capacity than that of the MMSE and IHDS. Community-specific cut-off values for HAND diagnosis, based on the MMSE and IHDS, make this protocol suitable for HAND screening in individuals from this Caribbean community. This study shows the effectivity of a recently proposed short protocol to detect HAND in individuals with asymptomatic HIV-1-Infection. The application of community-specific cut-off values for HAND diagnosis in the clinical setting may improve HAND screening accuracy and facilitate patients’ treatment and follow-up. Further studies are needed to assess the performance of this protocol in other Latin American populations.
Background
Body dissatisfaction (BD) is a growing concern in Latin America; reliable and culturally appropriate scales are vital to promote body image research in Spanish speaking Latin American countries. We validated a Latin American Spanish version of the Body Esteem Scale for Adolescents and Adults (BESAA; Mendelson et al., 2001).
Methods
The scale was translated, culturally adapted, and validated with adults in Colombia (N = 525, 65% women, Mage 24.4, SD = 9.28). We assessed factor structure (using confirmatory and exploratory factor analysis CFA and EFA), internal reliability (using Cronbach’s alpha and omega), validity (using the Body Appreciation Scale BAS and Sociocultural Attitudes Towards Appearance Questionnaire SATAQ), test-retest stability (using Intraclass correlations ICC) and measurement invariance. To evaluate the generalizability of the scale, we assessed reliability, validity, and factor structure in a second sample from rural Nicaragua (N = 102, 73% women, Mage 22.2, SD = 4.72).
Results
The scale showed excellent internal reliability and validity across both samples. Test-retest stability and invariance across gender was established for the Colombian sample. EFA showed a three-factor structure with the subscales appearance-positive, appearance-negative and weight that was confirmed using CFA in both the Colombian and Nicaraguan sample and showed invariance across countries.
Conclusion
The Latin American Spanish version BESAA-LA is a psychometrically sound measure with excellent reliability, validity and invariance across gender and countries. Therefore, we recommend its use in diverse Latin American adult populations to measure body satisfaction/dissatisfaction.
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