Factor Structure of Leigh’s (1990) Alcohol Sex Expectancies Scale in Individuals in Treatment for HIV Disease

Abstract

The purpose of this study was to validate the use of Leigh's (1990) alcohol sex expectancies scale among HIV-infected individuals presenting for treatment as a way to facilitate research on sexual risk reduction among individuals in that population. The participants were 944 men who presented for treatment at infectious disease or general medicine clinics across 8 different VA Medical Center sites. A total of 534 of these men were HIV-positive and 410 were HIV-negative. The total sample was randomly divided in half within each HIV group to form exploratory (Sample 1) and confirmatory (Sample 2) subsamples. A principal components factor analysis with oblique rotation of the original 13-item Leigh scale within each HIV group in Sample 1 revealed a 2-factor (7 and 4 items, respectively) solution that was consistent across both HIV groups. These factors were named "More Open to Sexual Pleasure" (Factor 1) and "Reduced Inhibitions about Sex (Factor 2)." A confirmatory factor analysis of the 11-item, 2-factor solution on the full Sample 2 showed a modest fit to the data, excellent internal consistency reliability of both factors, a high correlation between the factors, and strong evidence for construct validity. These results were interpreted as supporting the use of the 11-item, 2-factor version of Leigh's scale in studies of clinical samples of HIV-positive adults, and directions for research on further scale refinement are discussed.

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

“…Although the three derived factors-sex-related, negative, and release-of-inhibition expectancies-were consistent with previously published alcohol expectancy research (Kalichman et al, 2007;Leigh & Stacy, 1993;Maisto et al, 2010), it is noteworthy that the sex-related expectancies and release of inhibitions formed unique factors in our sample. This may be because most of the sex-related items in the AFEXS were similar to what Maisto et al (2010) labeled as "more open to sexual pleasure" (i.e., participants expected that alcohol would make them more open than if they were sober) rather than "reduced inhibitions about sex," allowing the formation of two distinct factors related to release from inhibitions and sexual enhancement. The validity correlations for the AFEXS were generally in the expected direction.…”

“…Forward and backward translation and cognitive interviewing ensured that all items developed with U.S.-based populations were culturally equivalent and appropriate for an HIV clinic in Uganda. The AFEXS showed excellent internal consistency, the three-factor solution was consistent with the design of the scale, and the percent variance explained was comparable to other published alcohol expectancy research with U.S.-based HIV-positive study participants (Maisto et al, 2010). Although the three derived factors-sex-related, negative, and release-of-inhibition expectancies-were consistent with previously published alcohol expectancy research (Kalichman et al, 2007;Leigh & Stacy, 1993;Maisto et al, 2010), it is noteworthy that the sex-related expectancies and release of inhibitions formed unique factors in our sample.…”

“…analyses were secondary), we did make a priori predictions based on the existing expectancy literature conducted in both the United States (Leigh & Stacy, 1993;Maisto et al, 2010;McMahon et al, 1994) and South Africa (Kalichman et al, 2007). Based on this previous research and the final three factors that emerged from the EFA, our hypotheses for the validity analyses were as follows: (A) The total score was expected to positively correlate with the AUDIT, frequency of intoxication, and the two items from the MRSEQ.…”

“…This is based on research showing that expectancy items related to "reduced inhibitions" have been shown to positively correlate with both the AUDIT and sexual risk behavior (Maisto et al, 2010).…”

“…Indeed, the measurement of alcohol expectancies has yielded a well-developed literature in the United States, which has produced several psychometrically validated scales available for use with adults and adolescents (Brown et al, 1987;Leigh, 1990;Leigh & Stacy, 1993) and people living with HIV/AIDS (Maisto et al, 2010). No such validated scale has been tested with HIV-positive adults, or any population, in sub-Saharan Africa.…”