Background: Spirituality contributes to better mental and physical health outcomes, including lower rates of HIV. However, there are few theoretically-sound, psychometrically-robust scales of spirituality that have been adequately tested among Black MSM in the Deep South.

Methods: As of December 2014, we enrolled 465 BMSM aged 18 years and older residing in the Deep South in the MARI Study. Participants completed an electronic survey containing measures of socio-demographics and multiple psychosocial factors. Spirituality was assessed using the Daily Spirituality Experiences Scale (DSES). Resilience, optimism, and social support were measured using validated scales. Principal component analysis was used to assess the factor structure of the DSES, and correlations examined bivariate associations with psychosocial resource factors.

Results: The mean age of participants was 30.3 years, and 39.4% were previously or newly diagnosed with HIV. Cronbach's α for the DSES was 0.96. The root mean square error of approximation (a measure of goodness-of-fit) was 0.127 denoting marginal model fit (acceptable model fit ≤0.06). Exploratory factor analyses suggested a one-factor solution (Tucker & Lewis Reliability Coefficient: 0.844). The DSES was positively correlated with organized religious participation, non-organized activities (e.g., prayer), and religious coping (r = 0.167-0.449, 0.421-0.511, and 0.189-0.288, respectively) as well as resilience (0.249-0.373), optimism (0.267), and social support (0.151-0.288), and varied these associations varied by age, HIV-serostatus and study site.

Conclusions: These findings suggest that the DSES may adequately operationalize spirituality among BMSM in the Deep South. However, the consideration of spirituality as a health-promoting factor among BMSM deserves further exploratio