Measurement of Stigma in People with HIV: A Reexamination of the HIV Stigma Scale

Abstract Background There is a dearth of instruments that have been developed and validated for use with children living with HIV under the age of 17 years in the Kenyan context. We examined the psychometric properties and measurement invariance of a short version of the Berger HIV stigma scale administered to perinatally HIV-infected adolescents in a rural setting on the Kenyan coast. Methods A cross-sectional study was conducted among 201 perinatally HIV-infected adolescents aged 12–17 years between November 2017 and October 2018. A short version of the Berger HIV stigma scale (HSS-40) containing twelve items (HSS-12) covering the four dimensions of stigma was evaluated. The psychometric assessment included exploratory factor analysis, confirmatory factor analysis (CFA), and multi-group CFA. Additionally, scale reliability was evaluated as internal consistency by calculating Cronbach’s alpha. Results Evaluation of the reliability and construct validity of the HSS-12 indicated insufficient reliability on three of the four subscales. Consequently, Exploratory Factor Analysis (EFA) was conducted to identify problematic items and determine ways to enhance the scale’s reliability. Based on the EFA results, two items were dropped. The Swahili version of this new 10-item HIV stigma scale (HSS-10) demonstrated excellent internal consistency with a Cronbach alpha of 0.86 (95% confidence interval (CI) 0.84–0.89). Confirmatory Factor Analysis indicated that a unidimensional model best fitted the data. The HSS-10 presented a good fit (overall Comparative Fit Index = 0.976, Tucker Lewis Index = 0.969, Root Mean Square Error of Approximation = 0.040, Standardised Root Mean Residual = 0.045). Additionally, multi-group CFA indicated measurement invariance across gender and age groups at the strict invariance level as ΔCFI was ≤ 0.01. Conclusion Our findings indicate that the HSS-10 has good psychometric properties and is appropriate for evaluating HIV stigma among perinatally HIV-infected adolescents on the Kenyan coast. Further, study results support the unidimensional model and measurement invariance across gender and age groups of the HSS-10 measure.

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HIV Stigma Scale

PsycTESTS Dataset ◽

10.1037/t19334-000 ◽

2001 ◽

Cited By ~ 1

Author(s):

Barbara Berger ◽

Carol Estwing Ferrans ◽

Felissa R. Lashley

Keyword(s):

Hiv Stigma ◽

Stigma Scale

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Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context

PLoS ONE ◽

10.1371/journal.pone.0114867 ◽

2014 ◽

Vol 9 (12) ◽

pp. e114867 ◽

Cited By ~ 15

Author(s):

Maria H. Lindberg ◽

Lena Wettergren ◽

Maria Wiklander ◽

Veronica Svedhem-Johansson ◽

Lars E. Eriksson

Keyword(s):

Psychometric Evaluation ◽

Hiv Stigma ◽

Stigma Scale

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Differential item functioning for items in Berger’s HIV Stigma Scale: an analysis of cohorts from the Indian, Swedish, and US contexts

Quality of Life Research ◽

10.1007/s11136-018-1841-4 ◽

2018 ◽

Vol 27 (6) ◽

pp. 1647-1659 ◽

Cited By ~ 2

Author(s):

Maria Reinius ◽

Deepa Rao ◽

Lisa E. Manhart ◽

Maria Wiklander ◽

Veronica Svedhem ◽

...

Keyword(s):

Differential Item Functioning ◽

Hiv Stigma ◽

Stigma Scale ◽

Item Functioning

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Adaptation of the HIV Stigma Scale in Spaniards with HIV

The Spanish Journal of Psychology ◽

10.1017/s1138741615000694 ◽

2015 ◽

Vol 18 ◽

Cited By ~ 1

Author(s):

Maria José Fuster-RuizdeApodaca ◽

Fernando Molero ◽

Francisco Pablo Holgado ◽

Silvia Ubillos

Keyword(s):

Factor Structure ◽

Opportunistic Infections ◽

Higher Order ◽

Hiv Stigma ◽

Confirmatory Factor Analyses ◽

Stigma Scale ◽

The People ◽

Good Internal Consistency ◽

Hiv Status Disclosure ◽

Order Four

AbstractThe primary goal of this study was to adapt Berger, Ferrans, & Lahley (2001) HIV Stigma Scale in Spain, using Bunn, Solomon, Miller, & Forehand (2007) version. A second goal assessed whether the four-factor structure of the adapted scale could be explained by two higher-order dimensions, perceived external stigma and internalized stigma. A first qualitative study (N = 40 people with HIV, aged 28–59) was used to adapt the items and test content validity. A second quantitative study analyzed construct and criterion validity. In this study participants were 557 people with HIV, aged 18–76. The adapted HIV Stigma Scale for use in Spain (HSSS) showed a good internal consistency (α = .88) and good construct validity. Confirmatory Factor Analyses yielded a first-order, four-factor structure and a higher-order, bidimensional structure with the two expected factors (RMSEA = .051, 90% CI [.046, .056]; RMR = .073; GFI = .96; AGFI = .96; CFI = .98). Negative relations were found between stigma and quality of life (r = –.39; p < .01), self-efficacy to cope with stigma (r = –.50; p < .01) and the degree of HIV status disclosure (r = –.35; p < .01). Moreover, the people who had suffered AIDS-related opportunistic infections had a higher score in the Perceived External Stigma dimension than those who had not suffered them, t (493) = 3.02, p = .003, d = 0.26.

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Evaluating the Measurement Structure of the Abbreviated HIV Stigma Scale in a Sample of African Americans Living With HIV/AIDS

Rehabilitation Research Policy and Education ◽

10.1891/2168-6653.30.1.65 ◽

2016 ◽

Vol 30 (1) ◽

pp. 65-76

Author(s):

Eboneé T. Johnson ◽

Rana A. Yaghmaian ◽

Andrew Best ◽

Fong Chan ◽

Reginald Burrell

Keyword(s):

Factor Analysis ◽

African Americans ◽

Social Stigma ◽

Hiv Stigma ◽

Good Reliability ◽

Stigma Scale ◽

Confirmatory Factor ◽

Valid Instrument ◽

Living With Hiv ◽

Hiv Aids

Purpose: The purpose of this study was to validate the 10-item version of the HIV Stigma Scale (HSS-10) in a sample of African Americans with HIV/AIDS.Method: One hundred and ten African Americans living with HIV/AIDS were recruited from 3 case management agencies in Baton Rouge, Louisiana. Measurement structure of the HSS-10 was evaluated using exploratory and confirmatory factor analysis.Results: Factor analysis results support a 2-factor factorial structure for the HSS-10 (social stigma and self-stigma). The HSS-10 demonstrates good reliability and factorial validity, and it correlates moderately with related constructs in the expected directions.Conclusion: HSS-10 is a brief, reliable, and valid instrument for assessing HIV stigma and can be used as a clinical rehabilitation and research tool to assess the contribution of stigma as a major cause of health disparities and outcomes in African Americans living with HIV/AIDS.

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