Psychometric Validation of the Connectedness to the LGBT Community Scale among Black Sexual Minority Men Living with HIV.

Abstract

LGBTQ + community connectedness is generally a protective health factor for sexual and gender minorities. However, existing scales have not been validated among Black sexual minority men living with HIV (SMMLWH), who face unique marginalized experiences that disproportionately impact several health outcomes compared to the general LGBT + community. We validated the Connectedness to the LGBT Community Scale among Black SMMLWH. We validated the 9-item Connectedness to the LGBT Community Scale from Frost and Meyer using preliminary data from a cohort of Mid-Atlantic Black SMMLWH (n = 650). Factor analysis and intercorrelations were conducted to assess unidimensionality, and Cronbach's alpha was measured for reliability. Correlations and cumulative ordinal regression models were generated using internalized homophobia, hopelessness, depression, HIV stigma, social support, and resilience as criterion constructs. Models were adjusted for sociodemographic and behavioral characteristics. The Connectedness to the LGBT Community Scale demonstrated high internal consistency (alpha = 0.948) and strong item intercorrelation with a single factor structure. The scale was associated with all criterion measures before and after adjustment, including lower internalized homophobia (aCOR = 0.19, 95% CI 0.15-0.25), lower hopelessness (aCOR = 0.53, 95% CI 0.41-0.68), lower HIV stigma (aCOR = 0.58, 95% CI 0.47-0.72), and lower depression (aCOR = 0.61, 95% CI 0.50-0.75). The scale was also associated with greater social support (aCOR = 2.38, 95% CI 1.91-2.97) and resilience (aCOR = 2.53, 95% CI 2.03-3.15). The Connectedness to the LGBT Community Scale is a valid measure for use among Black SMMLWH. Future studies should explore relationships between community connectedness and HIV care outcomes and quality of life among Black SMMLWH.