The assessment of health-related quality of life (HRQoL) in people living with HIV (PLHIV) has become crucial to evidence-based practice. The goals of this study are to analyze the psychometric properties and evidence of the validity of the Spanish version of WHOQOL-HIV-BREF in a sample of PLHIV in Spain and to examine the more impaired HRQoL facets and dimensions and identify the PLHIV who show the most vulnerable profile. A total of 1462 PLHIV participated in an observational cross-sectional ex-post-facto study. Data were collected at 33 Spanish sites through an online survey. In addition to measuring HRQoL, the study used other tools to measure treatment adherence (CEAT-VIH 2.0 version), psychological well-being (GHQ-12) and HIV-related stigma (HSSS). Cronbach’s alpha, first- and second-order confirmatory factor analysis (CFA), the Pearson coefficient and one-way ANOVA were used to evaluate reliability, construct validity and concurrent and known-group validity, respectively. Differences according to the socio-demographic and epidemiological profiles of participants were analyzed. First- and second-order CFAs confirmed a six-domain first-order structure of the Spanish version of WHOQOL-HIV-BREF and one second-order factor related to overall HRQoL with an acceptable fit to the data, although some minor changes would improve it. The six-domain structure showed an acceptable internal consistency (Cronbach’s alpha ranged from .61 to .81). Significant moderate to large correlations between domains and overall HRQoL, adherence, psychological well-being and negative self-image were found. Significant differences were found according to participants’ self-reported CD4+ cell count in several HRQoL facets and domains. Being female, heterosexual, having low socio-economic and educational statuses, having acquired HIV through an unsafe injection and living more years with HIV were related to poorer HRQoL. PLHIV older than 50 presented lower scores in 19 HRQoL facets. This study demonstrates that the Spanish version of the WHOQOL-HIV-BREF is a valid instrument. It also presents the most recent data about HRQoL in PLHIV in Spain with the largest sample to date.

中文翻译：

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评估西班牙艾滋病毒感染者的生活质量：西班牙语版本的WHOQOL-HIV-BREF的心理测验

对艾滋病病毒感染者（PLHIV）的健康相关生活质量（HRQoL）的评估已成为基于证据的实践的关键。这项研究的目的是在西班牙的PLHIV样本中分析西班牙文版WHOQOL-HIV-BREF的心理计量学特性和有效性的证据，并检查HRQoL面和维度受损程度更大的人，并找出表现出以下特征的PLHIV：最易受攻击的个人资料。共有1462名PLHIV参加了事后的观察性横断面研究。通过在线调查在33个西班牙站点收集了数据。除了测量HRQoL之外，该研究还使用其他工具来测量治疗依从性（CEAT-VIH 2.0版本），心理健康状况（GHQ-12）和与艾滋病相关的污名（HSSS）。克朗巴赫（Cronbach）的alpha，一阶和二阶确认因子分析（CFA），皮尔逊系数和单向方差分析分别用于评估信度，结构效度，并发效度和已知群体效度。根据参加者的社会人口统计学和流行病学特征分析了差异。一阶和二阶CFA确认了西班牙语版本的WHOQOL-HIV-BREF的六域一阶结构和一个与总体HRQoL相关的二阶因子，对数据的接受程度较高，尽管有些细微变化会有所改善它。六域结构显示出可接受的内部一致性（Cronbach's alpha范围从0.61到0.81）。发现域与总体HRQoL，依从性，心理健康和负面的自我形象之间存在显着的中度到较大的相关性。根据参与者在几个HRQoL方面和领域中自我报告的CD4 +细胞计数发现了显着差异。作为女性，异性恋，社会经济和教育地位低下，通过不安全的注射方式获得艾滋病毒并与艾滋病病毒一起生活了更多年，这与较差的HRQoL有关。年龄超过50岁的PLHIV在19个HRQoL方面的得分较低。这项研究表明，WHOQOL-HIV-BREF的西班牙语版本是有效的工具。它还提供了西班牙PLHIV中HRQoL的最新数据，是迄今为止最大的样本。年龄超过50岁的PLHIV在19个HRQoL方面的得分较低。这项研究表明，WHOQOL-HIV-BREF的西班牙语版本是有效的工具。它还提供了西班牙PLHIV中HRQoL的最新数据，是迄今为止最大的样本。年龄超过50岁的PLHIV在19个HRQoL方面的得分较低。这项研究表明，WHOQOL-HIV-BREF的西班牙语版本是有效的工具。它还提供了西班牙PLHIV中HRQoL的最新数据，是迄今为止最大的样本。