Measurement of self, experienced, and perceived HIV/AIDS stigma using parallel scales in Chennai, India

Abstract

HIV/AIDS stigma can severely compromise the quality of life of people living with HIV/AIDS (PLHA) by reducing access and quality of care, adherence to therapy, and disclosure of HIV status, thereby potentially increasing transmission. The objective of this study was to develop and psychometrically test three parallel scales measuring self, experienced, and perceived stigma among PLHA (n=188) in Chennai, India. Exploratory factor analysis (EFA), which was used to facilitate item reduction and assess construct validity, confirmed the presence of three underlying theoretical domains. The final number of items and Cronbach's Alpha for each scale were: 8 items, Alpha of 0.84, for self stigma; 7 items, Alpha of 0.86, for experienced stigma; and 7 items, Alpha of 0.83, for perceived stigma. External validity was ascertained by confirming a significant positive association between the measure of each type of stigma and depression (measured using CES-D), using structural equation modeling (SEM). Therefore, scales were parsimonious, reliable, and were found to be valid measures of HIV/AIDS stigma. Using these validated scales, researchers can accurately collect data to inform the design of stigma reduction programs and interventions and enable subsequent evaluation of their effectiveness.

Keywords:

• HIV/AIDS
• stigma
• scale
• India
• psychometrics

Acknowledgements

The Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) in Chennai, India, provided the infrastructure, operational, and logistical support for this study. This study was supported by a Doctoral Fund from the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Additional information

Notes on contributors

Sudha Sivaram

Current address: Sudha Sivaram, National Cancer Institute (NCI), National Institutes of Health (NIH), Rockville, MD, USA