The pre-exposure prophylaxis personal obstacle scale: measurement properties in English, German, and French.

Abstract

Background: This study aimed to validate the Pre-Exposure Prophylaxis Personal Obstacle Scale (PPOS) across English, German, and French (PPOS-EN/DE/FR) for men who have sex with men (MSM). The PPOS measures perceived barriers related to knowledge and uncertainty surrounding PrEP use, which are particularly important factors in the early stages of the PrEP Care Continuum (PCC).

Methods: The original PPOS was adapted and translated into German and French. Data were collected through an online survey in four European countries (N = 1124). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factor structure, while multigroup CFA (MGCFA) tested measurement invariance across language groups and adoption statuses.

Results: EFA revealed a two-factor structure: (i) "Impact of PrEP on personal health" and (ii) "Knowledge about PrEP." CFA confirmed this structure, and measurement invariance was established across languages and adoption statuses with high reliability (α = 0·82, ω = 0·82).

Conclusions: The PPOS-EN/DE/FR is a valid and reliable tool for assessing personal obstacles to PrEP uptake among MSM across different languages. It supports public health efforts by identifying specific challenges to PrEP adoption, facilitating culturally sensitive interventions to improve uptake and reduce HIV transmission.