title: Cross-Culture Validation of the HIV/AIDS Stress Scale: The Development of a Revised Chinese Version.
abstract: BACKGROUND
  Being HIV-infected is a stressful experience for many individuals. To assess HIV-related stress in the Chinese context, a measure with satisfied psychometric properties is yet underdeveloped. This study aimed to examine the psychometric characteristics of a simplified Chinese version of the HIV/AIDS Stress Scale (SS-HIV) among people living with HIV/AIDS in central China.
  
  
  METHODS
  A total of 667 people living with HIV (92% were male) were recruited from March 1st 2014 to August 31th 2015 by consecutive sampling. A standard questionnaire package containing the Chinese HIV/AIDS Stress Scale (CSS-HIV), the Chinese Patient Health Questionnaire-9 (PHQ-9), and the Chinese Generalized Anxiety Disorder Scale (GAD-7) were administered to all participants, and 38 of the participants were selected randomly to be re-tested in four weeks after the initial testing.
  
  
  RESULTS
  Our data supported that a revised 17-item CSS-HIV had adequate psychometric properties. It consisted of 3 factors: emotional stress (6 items), social stress (6 items) and instrumental stress (5 items). The overall Cronbach's α was 0.906, and the test-retest reliability coefficient was 0.832. The revised CSS-HIV was significantly correlated with the number of HIV-related symptoms, as well as scores on the PHQ-9 and GAD-7, indicating acceptable concurrent validity.
  
  
  CONCLUSIONS
  The 17-item Chinese version of the SS-HIV has potential research and clinical utility in identifying important stressors among the Chinese HIV-infected population and in understanding the effects of stress on adjustment to HIV.
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Niu
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Luo
authors.affiliation: Hunan provincial Center for Disease Control and Prevention, Changsha, Hunan, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: The First Hospital of Changsha, Changsha, Hunan, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: School of Psychology, University of Queensland, Brisbane, Australia.
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Pakenham
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, China.
authors.forename: Xixing
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Changsha Center for Disease Control and Prevention, Changsha, Hunan, China.
authors.forename: Zhulin
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Shuiyuan
authors.initials: S
authors.lastname: Xiao
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology*; D002681:China / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015203:Reproducibility of Results; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult