Translation of the Dimensional Apathy Scale to Brazilian Portuguese to assess people living with HIV

Neurocognitive and behavioral disorders are common among people living with HIV (PLHIV) and can be associated with apathy. The use of a valid and reliable instrument to identify apathy among PLHIV could allow early diagnosis and proper management of this condition. Objective: The aim of this paper was to translate, cross-culturally adapt, and validate the caregiverrated Dimensional Apathy Scale (DAS) in PLHIV in Brazil. Methods: We followed five steps: translation, back translation, cultural adaptation, pretest, and test–retest. A pretest (n=20) and test-retest (n=80) were conducted with PLHIV from an HIV Referral Center in Brazil between August 2022 and March 2023. We determined the content validity index (CVI), Cronbach’s alpha, and the intraclass correlation coefficient (ICC). To assess convergent and discriminant validity, apathy scores were correlated with cognitive function, as assessed by the International HIV Dementia Scale (IHDS), and depressive symptoms, as assessed by the Patient Health Questionnaire (PHQ-9). Results: Participants were predominantly male (82.5%), with a mean age of 41.7 (±13.4) years and a mean duration of infection of 8.1 (±1.9) years. The mean CVI of the Brazilian DAS version (DAS-Br) was 0.97. The translated version showed acceptable internal consistency (Cronbach’s alpha: 0.727 (95%CI 0.632–0.806)) and good test–retest reliability (ICC 0.888 (95%CI 0.823–0.929). There was a moderate correlation between DAS-Br scores and depressive symptoms (r=0.425, p<0.01) and a nonsignificant correlation with cognition (r=0.167; p>0.05). Conclusion: The translation and cross-cultural adaptation of the DAS into Brazilian Portuguese resulted in a valid and reliable instrument for assessing apathy in PLHIV.