The Construct Validity of the CES-D Among Hiv-infected Perinatal Thai Women: Explanatory and Confirmatory Factor Analysis - The Construct Validity of the CES-D Among Hiv-infected Perinatal Thai Women: Explanatory and Confirmatory Factor Analysis - Open Access Pub

It is important to measure depressive symptoms in HIV-infected individuals because depressive symptoms have been found to be correlated with faster progression to AIDS. Worldwide, the CES-D has been used to assess depressive symptoms and examined for its construct validity. However, no previous studies have investigated the CES-D’s construct validity among HIV-infected perinatal women. Therefore, the objective of this study was to examine the construct validity of the CES-D using both explanatory and confirmatory factor analysis among HIV-positive perinatal women in Thailand. Results showed that, overall, the CES-D is a 4-factor instrument with good construct validity and can be used to evaluate depressive symptoms among HIV-positive perinatal Thai women. However, some items from our study loaded differently on the 4 factors from Radloff’s model. Finally, the CES-D can be used as a general-factor scale without being compromised. DOI 10.14302/issn.2324-7339.jcrhap-12-158 HIV/AIDS is one of the most significant health problems worldwide, with serious impact on mortality, morbidity, the use of health care services, and the overall quality of life among those infected and the families and communities surrounding them.1 Affecting over 33 million people worldwide, including at least 600,000 Thai adults (ages 15-49), the epidemiology of HIV is changing globally.2 Overall, women of childbearing age are the fastest-growing group of individuals to be infected with HIV. In Thailand, over 21,000 pregnant women are infected.2 Generally, HIV infections cause greater problems for people in developing countries such as Thailand than for those in developed countries, partly because of a lack of antiretroviral medications. Studies have shown that depressive symptoms are associated with greater non-adherence to antiretroviral treatment,3 faster disease progression,4, 5 and poorer quality of life.6 Maternal depression is a significant cause of morbidity among child bearing women in resource-poor countries.7, 8 Thus, early detection of depression in the perinatal period is important. However, few studies of depressive symptoms in HIV-positive individuals have focused on pregnant and postpartum women, although the perinatal period is a time in which women are particularly vulnerable to depressive symptoms, partly due to hormonal changes.9, 10 Previous depressive symptoms,11 perceived stress, social isolation, disengagement coping,12 and drug use,13 have been found to be psychosocial and behavioral predictors of perinatal depressive symptoms as well. Studies that have