title: Conceptual equivalence of WHOQOL-HIV among people living with HIV in Ethiopia.
abstract: OBJECTIVE
  The WHOQOL instruments are intended for cross-cultural studies of quality of life (QoL) but African countries have been poorly represented in its development. This study aimed to explore the conceptual equivalence of WHOQOL-HIV in Ethiopia.
  
  
  METHODS
  The fieldwork included home visits, interviews, and focus group discussions with HIV patients and caregivers.
  
  
  RESULTS
  We found that although WHOQOL-HIV includes many relevant facets, its applicability has several limitations in the Ethiopian setting. The most salient shortcomings of the instrument relate to the Social, Environmental and Religion/Spirituality/Personal Beliefs domains of the instrument. Themes not captured by the instrument include family responsibilities, disease disclosure, exclusion from common resources, basic needs, adequate food, and job opportunities. In addition, several of the tool's facets such as dependence on medicine seem less relevant. Also, the role of religion is more complex than captured in WHOQOL-HIV. We found that the tool is based on an individualist focus, which tends to overlook the social context of the patient.
  
  
  CONCLUSIONS
  We conclude that the conceptual equivalence of WHOQOL-HIV is only partially attained for use in Ethiopia. The findings from this qualitative study are used in the further process of developing and validating a QoL instrument for use in Ethiopia.
authors.affiliation: Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg C, Denmark. meo@life.ku.dk
authors.forename: Mette
authors.initials: M
authors.lastname: Olsen
authors.forename: Natasja Koitzsch
authors.initials: NK
authors.lastname: Jensen
authors.forename: Markos
authors.initials: M
authors.lastname: Tesfaye
authors.forename: Lotte
authors.initials: L
authors.lastname: Holm
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D003469:Culture; D005002:Ethiopia; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014944:World Health Organization