Cross-cultural adaptation of the Perceived Risk of HIV Scale in Brazilian Portuguese

Thiago S. Torres, Paula M. Luz, Luana M.S. Marins, Daniel R.B. Bezerra, Celline C. Almeida-Brasil, Valdilea G. Veloso, Beatriz Grinsztejn, Daphna Harel, Brett D. Thombs

Research output: Contribution to journalArticlepeer-review


Background: Valid and reliable instruments are needed to measure the multiple dimensions of perceived risk. The Perceived Risk of HIV Scale is an 8-item measure that assesses how people think and feel about their risk of infection. We set out to perform a cross-cultural adaptation of the scale to Brazilian Portuguese among key populations (gay, bisexual and other men who have sex with men and transgender/non-binary) and other populations (cisgender heterosexual men and cisgender women). Methods: Methodological study with cross-sectional design conducted online during October/2019 (key populations [sample 1] and other populations) and February–March/2020 (key populations not on pre-exposure prophylaxis [sample 2]). Cross-cultural adaptation of the Perceived Risk of HIV Scale followed Beaton et al. 2000 guidelines and included confirmatory factor analysis, differential item functioning (DIF) using the Multiple-Indicator Multiple-Cause model, and concurrent validity to verify if younger individuals, those ever testing for HIV, and engaging in high-risk behaviors had higher scores on the scale. Results: 4342 participants from key populations (sample 1 = 235; sample 2 = 4107) and 155 participants from other populations completed the measure. We confirmed the single-factor structure of the original measure (fit indices for sample 1 plus other populations: CFI = 0.98, TLI = 0.98, RMSEA = 0.07; sample 2 plus other populations: CFI = 0.97, TLI = 0.95, RMSEA = 0.09). For the comparisons between key populations and other populations, three items (item 2: “I worry about getting infected with HIV”, item 4: “I am sure I will not get infected with HIV”, and item 8: “Getting HIV is something I have”) exhibited statistically significant DIF. Items 2 and 8 were endorsed at higher levels by key populations and item 4 by other populations. However, the effect of DIF on overall scores was negligible (0.10 and 0.02 standard deviations for the models with other populations plus sample 1 and 2, respectively). Those ever testing for HIV scored higher than those who never tested (p <.001); among key populations, those engaging in high-risk behaviors scored higher than those reporting low-risk. Conclusion: The Perceived Risk of HIV Scale can be used among key populations and other populations from Brazil.

Original languageEnglish (US)
Article number117
JournalHealth and Quality of Life Outcomes
Issue number1
StatePublished - Dec 2021


  • Brazil
  • GBM
  • HIV perceived risk
  • HIV risk-behavior
  • Perceived risk of HIV Scale
  • Psychometric properties
  • Transgender
  • Humans
  • Middle Aged
  • Male
  • Young Adult
  • Sexual and Gender Minorities/psychology
  • Ethnicity/psychology
  • Homosexuality, Male/psychology
  • Brazil/epidemiology
  • Adult
  • Female
  • Risk Assessment/methods
  • Surveys and Questionnaires/standards
  • Reproducibility of Results
  • Cross-Sectional Studies
  • Transgender Persons/psychology
  • Factor Analysis, Statistical
  • Cross-Cultural Comparison
  • Adolescent
  • HIV Infections/epidemiology

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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