# Adaptation and validation of HIV/AIDS module for university students in Larkana, Sindh, Pakistan

## TL;DR

This study adapts and validates an HIV/AIDS educational module for university students in Pakistan to improve accurate knowledge and reduce misconceptions.

## Contribution

A culturally adapted and validated HIV/AIDS educational module for university students in Pakistan is developed and tested.

## Key findings

- The module achieved high face and content validity scores among students and experts.
- Strong inter-rater agreement was observed using Fleiss’ Kappa Index and Content Validity Indices.
- The module is culturally sensitive and effective for HIV/AIDS education in low- and middle-income settings.

## Abstract

University students in Pakistan frequently possess limited and inaccurate understanding of HIV/AIDS, including misconceptions about how it spreads, immunity, and treatment. This knowledge gap increases their vulnerability, as young adults are a high-risk group for new infections. The study focused on adapting and validating a culturally suitable HIV/AIDS educational module specifically for university students in Larkana, Sindh, Pakistan. The validation process consisted of three stages: (i) adapting an existing HIV/AIDS educational package; (ii) conducting qualitative research with religious scholars to confirm its cultural and contextual relevance; and (iii) performing face and content validation with university students and public health experts. Forty-eight students evaluated face validity using a binary scale, while six subject-matter experts and five religious scholars assessed content validity via a 4-point Likert scale. Fleiss’ Kappa Index (FKI) was employed to measure inter-rater agreement, and Content Validity Indices (CVI) were calculated to assess overall content validity. High agreement levels were observed: students (Kappa = 0.80) and experts (Kappa = 0.82) showed strong consensus on the clarity and relevance of the module content. The Scale-level Content Validity Index (S-CVI/Ave) was above 0.90 for both groups, 0.95 for experts, and 0.94 for religious scholars, exceeding recommended standards. These results suggest that the module is both acceptable and effective in delivering HIV/AIDS information in a culturally sensitive way. This study demonstrates that a well-adapted HIV/AIDS educational module can achieve high validity when tailored to local cultural and religious contexts. The module shows promise as a model that can be replicated for HIV prevention and health education programmes among youth in similar low- and middle-income settings.