Reliability and validity of the Turkish translation of the MOS-HIV health survey in people living with HIV.

BACKGROUND

Health-related quality of life (HRQoL) is a key patient-centered outcome in HIV care, particularly in the current treatment era in which virological control is increasingly achievable but residual physical, mental, and social burden may persist. However, the clinical applicability of HIV-specific HRQoL instruments in Turkish-speaking people living with HIV (PLWH) remains insufficiently established. We aimed to characterize HRQoL in a multicenter Turkish sample of PLWH and to evaluate whether the Turkish version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) provides reliable and valid scores for use in this population.

METHODS

In this multicenter cross-sectional study, PLWH receiving care at five tertiary training and research hospitals in Istanbul completed the Turkish MOS-HIV. Cognitive debriefing was performed in 20 participants, and 244 were included in the main analysis. Domain and summary scores were calculated according to the user's manual. Internal consistency was assessed in all 244 participants and test-retest reliability in a subsample of 105 after a median of 15 days. Structural validity was examined using domain-level confirmatory factor analysis and known-groups comparisons were conducted according to comorbidity status, CD4 category, history of AIDS-defining illness, and number of tablets in the treatment regimen.

RESULTS

Participants had a median age of 37 years and a median CD4 count of 701 cells/mm3; 13.5% had detectable HIV-1 RNA. Floor effects were minimal, whereas ceiling effects were pronounced for role functioning and social functioning and notable for physical functioning and pain. Internal consistency was acceptable across all multi-item domains (Cronbach's α, 0.770-0.924), and test-retest reliability was satisfactory [ICC (2,1), 0.708-0.850]. A parsimonious two-factor domain-level structure was supported. Clinically, comorbidity, CD4 < 500 cells/mm3, and a history of AIDS-defining illness were associated with poorer scores in selected domains, whereas scores did not differ by tablet burden.

CONCLUSION

The Turkish MOS-HIV showed acceptable reliability and structural validity in a young, predominantly male, virologically suppressed population in urban tertiary care, and distinguished HRQoL differences by comorbidity, CD4 status, and history of AIDS-defining illness but not by tablet burden. Evaluation in women, older PLWH and more clinically heterogeneous populations is needed before broader use.