Development and validation of the East Africa Alcohol Expectancy Scale (AFEXS).

OBJECTIVE The purpose of this study was to develop and validate the East Africa Alcohol Expectancy Scale (AFEXS), a measure of alcohol expectancies for use with HIV-positive adults in East Africa. METHOD The study was conducted in several phases. The first involved development of the scale and an exploratory factor analysis (EFA) with a total of 209 HIV-positive, Ugandan men (n = 120) and women (n = 89). The second phase involved a confirmatory factor analysis (CFA) as well as validity analyses with a second, demographically similar, sample of 181 HIV-positive Ugandan men (n = 109) and women (n = 72). All participants were recruited from two ongoing cohort studies taking place at an HIV clinic in rural southwestern Uganda. RESULTS The EFA resulted in a 13-item, three-factor scale that explained 67% of the variance and showed excellent internal consistency (α = .89). The CFA showed good model fit with a final 11-item scale, χ(2)(41) = 68.60, p = .004; comparative fit index = .97; root mean square error of approximation = .06, 90% CI [.03, .09], that again showed excellent internal consistency and yielded the following three factors: sex-related (α = .94), release of inhibition (α = .61), and negative expectancies (α = .73). CONCLUSIONS The AFEXS is the first psychometrically validated alcohol expectancy scale available for use in Africa. The extent to which the AFEXS can be used with other populations and with adults from countries outside of East Africa requires ongoing validation.

[1]  C. Steinmaus,et al.  An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions , 2013 .

[2]  J. Hahn,et al.  Adding Fuel to the Fire: Alcohol’s Effect on the HIV Epidemic in Sub-Saharan Africa , 2011, Current HIV/AIDS reports.

[3]  S. Maisto,et al.  Alcohol expectancy challenges for college students: a narrative review. , 2011, Clinical psychology review.

[4]  R. Cook,et al.  Factor Structure of Leigh’s (1990) Alcohol Sex Expectancies Scale in Individuals in Treatment for HIV Disease , 2010, AIDS and Behavior.

[5]  S. Kalichman,et al.  Prevalence and clinical implications of interactive toxicity beliefs regarding mixing alcohol and antiretroviral therapies among people living with HIV/AIDS. , 2009, AIDS patient care and STDs.

[6]  S. Kalichman,et al.  HIV/AIDS Risks among Men and Women Who Drink at Informal Alcohol Serving Establishments (Shebeens) in Cape Town, South Africa , 2008, Prevention Science.

[7]  P. Vanable,et al.  Alcohol use, partner type, and risky sexual behavior among college students: Findings from an event-level study. , 2007, Addictive behaviors.

[8]  S. Kalichman,et al.  Alcohol expectancies and risky drinking among men and women at high-risk for HIV infection in Cape Town South Africa. , 2007, Addictive behaviors.

[9]  W. George,et al.  Alcohol use, expectancies, and sexual sensation seeking as correlates of HIV risk behavior in heterosexual young adults. , 2007, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[10]  K. D. de Cock,et al.  HIV prevention for a threatened continent: implementing positive prevention in Africa. , 2006, JAMA.

[11]  J. Schiffman,et al.  Effects of alcohol, expectancies, and partner type on condom use in college males: Event‐level analyses , 2005, Journal of sex research.

[12]  Jason W. Osborne,et al.  Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. , 2005 .

[13]  K. Carey,et al.  Effects of alcohol and expectancies on HIV-related risk perception and behavioral skills in heterosexual women. , 2004, Experimental and clinical psychopharmacology.

[14]  N. Lee,et al.  The relationship of positive and negative alcohol expectancies to patterns of consumption of alcohol in social drinkers. , 1999, Addictive behaviors.

[15]  B. Leigh,et al.  Alcohol Outcome Expectancies: Scale Construction and Predictive Utility in Higher Order Confirmatory Models , 1993 .

[16]  O. Aasland,et al.  Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. , 1993, Addiction.

[17]  M. Goldman,et al.  The Alcohol Expectancy Questionnaire: an instrument for the assessment of adolescent and adult alcohol expectancies. , 1987, Journal of studies on alcohol.

[18]  M. Goldman,et al.  Alcohol expectancy theory: The application ofcognitive neuroscience , 1999 .

[19]  P. Bentler,et al.  Fit indices in covariance structure modeling : Sensitivity to underparameterized model misspecification , 1998 .

[20]  Patrick J. O'Donnell,et al.  Comparing Positive and Negative Alcohol Expectancies in Male and Female Social Drinkers , 1994 .

[21]  B. Leigh.  Alcohol expectancies and reasons for drinking: Comments from a study of sexuality. , 1990 .

[22]  Global status report on alcohol and health , 2022 .