Flavell, Carol Ann, Crowe, Michael, Kenchington, Penny, Jones, Anne, Barker, Ruth, and O'Brien, Kelly (2026) Disability and frailty in people living with Human Immunodeficiency Virus in regional Australia: A cross-sectional study with a measurement property assessment of the HIV Disability Questionnaire Shortened Version: Human Immunodeficiency Virus in regional Australia. HIV Medicine. (In Press)

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Abstract

Objectives

To measure disability and frailty and assess measurement properties of the HIV Disability Questionnaire (HDQ) in outer regional Australian people living with human immunodeficiency virus (HIV).

Methods

This cross-sectional, validity and reliability study included community-dwelling outer regional Australian adults with HIV. Participants completed the self-reported World Health Organization Disability Assessment Schedule 2.0 (WHODAS; scored 0–100), 5-Question Frail Scale (scored 0–5) and HDQ (scored 0–100). Median scores (Q1, Q3) for disability (WHODAS) and frailty (Frail Scale) were reported. HDQ validity was tested based on 16 a priori hypothesized relationships between WHODAS, Frail Scale and HDQ scores (threshold ≥75% confirmed), and HDQ internal consistency with Cronbach's alpha (acceptability threshold ≥ 0.70). Seven days after the initial completion, the HDQ was re-administered for test–retest reliability (intraclass correlation coefficient, acceptability threshold ≥ 0.75).

Results

Fifty participants were recruited, with a median age 55. Eighty-eight percent were male, and 38 participants completed the second HDQ. The median (Q1, Q3) scores were: WHODAS 9 (3,17), with domain scores ranging from 0 to 56. Pre-frailty (score 1–2) and Frailty (score 3–5) were present in 27% and 13% of participants, respectively. The HDQ demonstrated construct validity (81% hypotheses confirmed), internal consistency (Cronbach's alpha ≥ 0.79), except in the Episodic scale-Social inclusion domain (alpha = 0.34), and good test–retest reliability for all Presence and Severity domains (ICC range: 0.77–0.94).

Conclusions

Disability, frailty and pre-frailty exist in this sample of outer regional Australians living with HIV. The HDQ showed acceptable construct validity, internal consistency and test–retest reliability to measure disability in this population. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12623000090617).

Item ID:	90952
Item Type:	Article (Research - C1)
ISSN:	1468-1293
Copyright Information:	This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2026 The Author(s). HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association
Date Deposited:	09 Mar 2026 23:19
FoR Codes:	42 HEALTH SCIENCES > 4203 Health services and systems > 420318 People with disability @ 100%
SEO Codes:	20 HEALTH > 2004 Public health (excl. specific population health) > 200403 Disability and functional capacity @ 100%
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