HIV-positive identity and health behaviors in adolescents living with HIV

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Ron E. Duran - Committee Chair


This dissertation study provided validation support for the construct of HIV-positive identity as well as for the HIV-Positive Identity Questionnaire (HIVPIQ) which contained conceptually-generated items comprising two non-additive scales, HIV-positive Identity Salience and HIV-positive Identity Valence. This dissertation project was comprised of two studies. In Study 1 items for the HIVPIQ scales were piloted in a sample of 114 adults with HIV. Reliability and factor analyses were used to reduce the items to scales with unitary factor structures. One salience scale and two valence scales, all with good internal reliability, were derived. Study 2 examined the factor structure and reliability of the Salience and Valence scales in a sample of 52 behaviorally-infected adolescents (between the ages of 16 and 21) living with HIV. A second round of exploratory item and factor analysis confirmed the composition of the initial valence scales and resulted in the construction of an alternate salience scale, Salience-Adolescent. Convergent and discriminant reliability information provided good support for the Valence scales and moderate support for the Salience scales. HIV-positive identity salience was positively associated with spontaneously mentioning status in a free response exercise and was also positively associated with perceived stigma. Both HIV-positive valence scales were positively related to optimism and negatively related to HIV-related stigma and depression. Valence - Low Negative Affect was positively related to self esteem and Valence - Positive Expectancy was positively associated with relationship with health care provider. Relationships among the construct of HIV-positive identity and health-related parameters including sexual risk behavior, safer sex self-efficacy, HIV medication adherence, and HIV knowledge were investigated. Valence - Low Negative Affect was negatively associated with number of sexual partners, while Valence - Positive Expectancy was positively associated with HIV knowledge. Counter-intuitively, Valence - Positive Expectancy was negatively associated with condom use during vaginal sex. Stigma and optimism moderated some of the relationships between the salience and valence variables and health-related outcome measures with greater optimism enhancing positive relationships of identity valence with HIV knowledge and sexual risk self-efficacy. Additional exploration of the relationships among identity salience, identity valence and stigma were explored. Perceived stigma partially mediated the significant negative relationship between identity salience and valence. The theoretical implications of findings are discussed in relation to HIV-positive identity formation as a developmental process in adolescents living with HIV.


Psychology, Clinical

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