title: Developing a valid and reliable instrument to predict the protective sexual behaviors in women at risk of human immunodeficiency virus.
abstract: BACKGROUND
  One much needed tool to assist with the monitoring and evaluation of Human Immunodeficiency Virus (HIV) prevention programs is to provide a valid instrument to measure protective sexual behavior and related factors.
  
  
  OBJECTIVE
  The current study aimed to design a valid and reliable instrument to predict the protective sexual behaviors of women at risk of HIV in Iran.
  
  
  METHODS
  The current study was a sequential mixed cross-sectional and methodological research. Initially, via a qualitative research, constructs and factors associated with sexual protective behavior of women at risk were identified through 25 in-depth interviews. The questionnaire on predictors of protective sexual behaviors in women at risk of HIV (PSPB) was designed based on a qualitative study, and then its qualitative validity, content, and construct validity were evaluated. Exploratory factor analysis was performed and 200 women at risk participated.
  
  
  RESULTS
  Seven concepts emerged after exploratory factor analysis of the 48 items. The content validity ratio (CVR) of the questionnaire constructs were 0.55 to 0.76, and content validity index (CVI) structure was 0.86 to 0.95. Cronbach's alpha coefficient for the entire questionnaire was 0.78, and correlation coefficient of the test-retest reliability for the constructs was from 0.73 to 0.89.
  
  
  CONCLUSIONS
  The current study proved the capability of the predictors of sexual protective behavior in women at risk for HIV questionnaire as a valid and reliable instrument for the Iranian community.
authors.affiliation: Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, IR Iran ; Department of Midwifery and Reproductive Health, Alborz University of Medical Sciences, Karaj, IR Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Lotfi
authors.affiliation: Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Ramezani Tehrani
authors.affiliation: Department of Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Yaghmaei
authors.affiliation: Department of Biostatistics, Tarbiat Modares University, Tehran, IR Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Hajizadeh
keywords: Questionnaires; Vulnerable Populations; Women