Development and Psychometric Evaluation of the HIV-Related Stigma in Health Facilities (HIV-SHF) Scale
Abstract
Objective: The literature presents a variety of Human Immunodeficiency Virus (HIV) stigma scales focused on the self, social aspects, and health worker issues. Scarcity was noted on instruments developed to assess HIV-related stigma in health facilities. This paper aims to present the rigors in designing and developing a psychometrically reliable and valid scale to assess HIV-related stigma in health facilities.
Material and Methods: A sequential exploratory mixed method design was utilized following a Qual-Quan approach. Key informant interviews were used to gather first-hand experience of stigma in health facilities among key populations and persons living with HIV. Thematic analysis was utilized to analyze the narratives and pick out statements for item generation in the scale. The quantitative phase was done through item and scale validation, exploratory factor analysis, and reliability assessment using Cronbach’s alpha.
Results: Two factors were extracted which were categorized as (1) Facility Structure and Protocol, and (2) Health Personnel. The scale has very high internal consistency as per Cronbach’s alpha value of 0.91, suggestive of its high reliability in measuring HIV-related stigma in health facilities.
Conclusion: The scale may be utilized by health facilities to assess and evaluate their health service provision, particularly on their client’s perception of health facility-related stigma.
Keywords
Full Text:
PDFReferences
UNAIDS. Global HIV & AIDS statistics-fact sheet [homepage on the Internet]. Beijing: UNAIDS; 2022 [cited 2020 Feb 28]. Available from: https://www.unaids.org/sites/default/files/ media_asset/UNAIDS_FactSheet_en.pdf
UNAIDS. Core epidemiology slides [homepage on the Internet]. Beijing: UNAIDS; 2021 [cited 2022 Feb 28] Available from: http://unaids.org/en/resources/documents/2021/coreepidemiology- slides
Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav 2009;13:1160-77.
De los Santos JAA. Healthcare workers attitude and stigma among people living with HIV/AIDS (PLHA): a literature review. J Health Caring Sci 2020;18:150-66.
Li Z, Morano JP, Khoshnood K, Hsieh E, Sheng Y. HIV-related stigma among people living with HIV/AIDS in rural Central China. BMC Health Serv Res 2018;18:453.
De los Santos JAA. Illuminating the experience of stigma among people living with HIV using participative drawing method. Nurse Media J Nurs 2022;12:196-207.
De los Santos JAA, Tuppal CP, Milla NE. The correlates of health facility-related stigma and health-seeking behaviors of people living with HIV. Acta Med Philipp 2022.
Ziersch A, Walsh M, Baak M, Rowley G. Oudih E, Mwanri L. “It is not an acceptable disease”: A qualitative study of HIV-related stigma and discrimination and impacts on health and wellbeing for people from ethnically diverse backgrounds in Australia. BMC Public Health 2021;21:779.
Moussa AB, Delabre RM, Villes V, Elkhammas M, Bennani A, Ouarsas L et al. Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco. BMC Public Health 2021;21:163.
Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health 2001;24:518-29.
Wiklander M, Rydström LL, Ygge BM, Navér L, Wettergren L, Eriksson LE. Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection. Health Qual Life Outcomes 2013;11:195.
Wanjala SW, Ssewanyana D, Mwangala PN, Nasambu C, Chongwo E, Luchters S, et al. Validity, reliability, and measurement invariance of an adapted short version of the HIV stigma scale among perinatally HIV infected adolescents at the Kenyan coast. Glob Health Res Policy 2021;6:49.
Yu CH, Huang CY, Lee YT, Cheng SF. Development of an 18-item abbreviated Chinese version of Berger’s HIV Stigma Scale. Int J Nurs Pract 2019;25:e12708.
Jeyaseelan L, Kumar S, Mohanraj R, Rebekah G, Rao D, Manhart LE. Assessing HIV/AIDS stigma in south India: validation and abridgement of the Berger HIV Stigma scale. AIDS Behav 2013;17:434-43.
Lindberg MH, Wettergren L, Wiklander M, Svedhem-Johansson V, Eriksson LE. Psychometric evaluation of the HIV stigma scale in a Swedish context. PLoS One 2014;9:e114867.
Franke MF, Muñoz M, Finnegan K, Zeladita J, Sebastian JL, Bayona JN, et al. Validation and abbreviation of an HIV stigma scale in an adult spanish-speaking population in urban Peru. AIDS Behav 2010;14:189-99.
Saine ME, Moore TM, Szymczak JE, Bamford LP, Barg FK, Mitra N, et al. Validation of a modified Berger HIV stigma scale for use among patients with hepatitis C virus (HCV) infection. PLoS One 2020;15:e0228471.
Siegler AJ, Wiatrek S, Mouhanna F, Amico KR, Dominguez K, Jones J, et al. Validation of the HIV pre-exposure prophylaxis stigma scale: performance of likert and semantic differential scale versions. AIDS Behav 2020;24:2637-49.
Geibel S, Gottert A, Friedland BA, Jeremiah K, McClair TL, Mallouris C, et al. Internalized stigma among people living with HIV: assessing the Internalized AIDS-Related Stigma Scale in four countries. AIDS 2020;34(Suppl 1):S33-41.
Visser MJ, Kershaw T, Makin JD, Forsyth BW. Development of parallel scales to measure HIV-related stigma. AIDS Behav 2008;12:759-71.
Pantelic M, Boyes M, Cluver L, Thabeng M. ‘They say HIV is a punishment from god or from ancestors’: cross-cultural adaptation and psychometric assessment of an HIV stigma scale for South African adolescents living with HIV (ALHIV-SS). Child Indic Res 2018;11:207-23.
Kerrigan D, Karver TS, Barrington C, Davis W, Donastorg Y, Perez M, et al. Development of the experiences of sex work stigma scale using item response theory: implications for research on the social determinants of HIV. AIDS Behav 2021;25:175-88.
Kamitani E, Chen JL, Portillo C, Tokumoto J, Dawson-Rose C. Shortened and culturally appropriate HIV stigma scale for Asians living with HIV in the United States: psychometric analysis. J Assoc Nurses AIDS Care 2018;29:560-9.
Yang LH, Ho-Foster AR, Becker TD, Misra S, Rampa S, Poku OB, et al. Psychometric validation of a scale to assess culturally-salient aspects of HIV stigma among women living with HIV in Botswana: engaging "what matters most" to resist stigma. AIDS Behav 2021;25:459-74.
Reisner SL, Moore CS, Asquith A, Pardee DJ, Mayer KH. Gender Non-affirmation from cisgender male partners: development and validation of a brief stigma scale for HIV research with transgender men who have sex with men (Trans MSM). AIDS Behav 2020;24:331-43.
De los Santos JAA, Milla NE, Tuppal CT, Labrague LJ. Development and psychometric evaluation of the nurse behavior toward confirmed and suspected HIV/AIDS patients (NBCSHAP) Scale. Frontiers Nurs 2022;9:103-114.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2008;3:77-101.
Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills: Sage; 1985.
DeVellis R. Scale development: theory and applications. 3rd ed. California: Sage; 2012.
Salvador J, Alqahtani FM, Al-Garni RSS. Development of Filipino nurse educator’s wellbeing survey (FNEWS): an exploratory sequential mixed-method study. Open Nurs J 2019;13:139-52.
Fauk NK, Ward PR, Hawke K, Mwanri L. HIV Stigma and discrimination: perspectives and personal experiences of healthcare providers in Yogyakarta and Belu, Indonesia. Front Med (Lausanne) 2021;8:625-787.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.