Cultural adaptation and psychometric validation of the Amharic adherence barriers questionnaire for HIV patients on antiretroviral therapy in Ethiopia

Adherence to antiretroviral therapy (ART) is essential for effective HIV management, yet various barriers can undermine adherence and lead to poor treatment outcomes. However, tools to systematically identify these barriers are lacking in Ethiopia, and the Adherence Barriers Questionnaire for HIV patients (ABQ-HIV) can fill this gap. This study aimed to culturally adapt and validate the Adherence Barriers Questionnaire for HIV patients (ABQ-HIV) into Amharic for use among HIV patients on ART in Ethiopia. A cross-sectional study conducted among 200 HIV patients receiving ART. The ABQ-HIV translated into Amharic using standard forward–backward procedures. Psychometric evaluation included internal consistency testing with Cronbach’s alpha, split-half reliability using the Spearman–Brown coefficient, convergent validity assessed through correlation with the Morisky Medication Adherence Scale (MMAS), and confirmatory factor analysis (CFA). Data analyzed using STATA-17. The Amharic ABQ-HIV showed good reliability, with a Cronbach’s alpha of 0.829 for the initial 15-item scale. One item (item 8) was removed due to cultural irrelevance, resulting in a 14-item scale with improved reliability (α = 0.834). Split-half reliability coefficients were 0.83 and 0.70. Confirmatory factor analysis (CFA) indicated better model fit for the reduced scale, and convergent validity was supported by a significant negative correlation with MMAS scores. Overall, 62.5% of participants reported at least one adherence barrier, mainly unintentional barriers. The 14-item Amharic ABQ-HIV is a valid and reliable instrument for identifying ART adherence barriers in Ethiopia, providing a practical tool for clinicians and researchers to improve adherence interventions.