Introduction
Methods
Phase 1. Item reduction
Subscale | Description of content excerpted from Berger et al.a
| Interpretation of main aspects | Questions selected for the short version of the HIV Stigma Scale |
---|---|---|---|
Personalised stigma | ‘…Perceived consequences of other people knowing that the respondent has HIV, such as losing friends, feeling that people were avoiding him/her, and regrets for having told people’. | 1. Losing friends and fear of rejection. | 29. People I care about stopped calling after learning I have HIV |
36. I have lost friends by telling them I have HIV | |||
2. Feeling that people avoid me. | 28. Some people avoid touching me if they know I have HIV | ||
3. Regrets for having told people about my HIV status | All items regarding this aspect cross-loaded in analyses or had underfit | ||
Disclosure concerns | ‘…controlling information, keeping one’s HIV status a secret, or worrying that others who knew about respondent’s HIV status would tell’. | 1. Keeping my HIV status a secret | 4. Telling someone I have HIV is risky |
6. I work hard to keep my HIV a secret | |||
17. I am very careful who I tell that I have HIV | |||
2. Worrying that others will disclose my HIV status | All items regarding this aspect cross-loaded in the analyses or had underfit | ||
Concerns about public attitudes | ‘…what most people think about people with HIV or what most people with HIV can expect when others learn they have HIV … the consequences of people in general knowing about a person having HIV’. | 1. What most people think about people with HIV | 10. Most people believe a person who has HIV is dirty |
20. Most people are uncomfortable around someone with HIV | |||
2. Consequences of people in general knowing about a person having HIV | 9. People with HIV are treated like outcasts | ||
Negative self-image | ‘…feeling unclean, not as good as others or like a bad person because of HIV … feelings of shame and guilt’. | 1. Negative feelings, guilt, shame, feeling unclean | 2. I feel guilty because I have HIV |
2. Feeling like I am a bad person because of HIV | 7. I feel I’m not as good a person as others because I have HIV | ||
3. People’s attitudes about HIV make me feel worse about myself |
Step 1. Removing items with underfit
Step 2. Removing cross-loading items
Step 3. Keeping as many aspects as possible
Phase 2. Psychometric evaluation of the short version of the HIV stigma scale
Participants
Construct validity
Reliability
Results
Phase 1. Item reduction
Items | Component | Outfit Msqr | Infit Msqr | |||
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | |||
39. People seem afraid of me once they learn I have HIV | 0.866 | 0.485 | 0.511 | |||
29. People I care about stopped calling after learning I have HIV | 0.864 | 0.592 | 0.661 | |||
38. People who know I have HIV tend to ignore my good points | 0.833 | 0.530 | 0.557 | |||
28. People avoid touching me once they know I have HIV | 0.824 | 0.654 | 0.748 | |||
35. I have stopped socializing with some people due to their reaction to me having HIV | 0.776 | 0.641 | 0.702 | |||
36. I have lost friends by telling them I have HIV | 0.770 | 0.748 | 0.869 | |||
33. People have physically backed away from me when they learn I have HIV | 0.726 | 0.729 | 0.735 | |||
24. I have been hurt by how people reacted to learning I have HIV | 0.721 |
1.337
|
1.267
| |||
32. People don’t want me around their children once they know I have HIV | 0.714 | 0.975 | 1.013 | |||
30. Some people told me that getting HIV is what I deserve for how I have lived my life | 0.700 | 1.164 |
1.383
| |||
27. As a rule, telling others that I have HIV has been a mistake | 0.677 | 0.344 | 1.159 |
1.205
| ||
31. Some people close to me are afraid others will reject them if it becomes known that I have HIV | 0.671 | 1.093 | 1.101 | |||
26. I regret having told some people that I have HIV | 0.642 | 0.327 |
1.680
|
1.505
| ||
34. Some people act as though it’s my fault I have HIV | 0.638 |
1.212
| 0.881 | |||
40. When people learn you have HIV, they look for flaws in your character | 0.627 |
1.262
| 0.978 | |||
18. Some people who know I have HIV have grown more distant | 0.604 |
1.999
|
1.456
| |||
6. I work hard to keep my HIV a secret | 0.751 | 0.580 | 0.627 | |||
17. I am very careful who I tell that I have HIV | 0.746 | 0.637 | 0.686 | |||
1. In many areas of my life, no one knows I have HIV | 0.696 |
1.559
| 1.142 | |||
21. I never feel I need to hide the fact I have HIV (R) | 0.575 | −0.411 |
1.334
|
1.291
| ||
4. Telling someone I have HIV is risky | 0.614 | 0.870 | 0.804 | |||
25. I worry people who know I have HIV will tell others | 0.362 | 0.542 | 0.841 | 0.858 | ||
22. I worry that people may judge me when they learn I have HIV | 0.493 | 0.763 | 0.733 | |||
37. I have told people close to me to keep the fact that I have HIV a secret | 0.402 |
1.333
|
1.248
| |||
15. Having HIV makes me feel that I’m a bad person | −0.737 | 0.667 | 0.725 | |||
7. I feel I’m not as good a person as others because I have HIV | -0.698 | 0.738 | 0.696 | |||
3. People’s attitudes about HIV make me feel worse about myself | −0.665 | 0.762 | 0.817 | |||
8. I never feel ashamed of having HIV (R) | -0.654 |
1.361
|
1.406
| |||
12. Having HIV makes me feel unclean | −0.570 | 0.778 | 0.790 | |||
2. I feel guilty because I have HIV | -0.532 | 1.105 | 1.022 | |||
23. Having HIV in my body is disgusting to me | −0.530 | 0.970 | 0.991 | |||
13. Since learning I have HIV, I feel set apart and isolated from the rest of the world | 0.357 | −0.484 | 0.983 | 0.967 | ||
20. Most people are uncomfortable around someone with HIV | -0.769 | 0.550 | 0.560 | |||
9. People with HIV are treated like outcasts | −0.639 | 1.016 | 0.941 | |||
14. Most people think that a person with HIV is disgusting | −0.613 | 0.865 | 0.806 | |||
10. Most people believe a person who has HIV is dirty | −0.599 | 0.734 | 0.760 | |||
16. Most people with HIV are rejected when others find out | −0.598 | 1.049 | 1.076 | |||
5. People with HIV lose their jobs when employers find out | −0.477 |
1.243
|
1.206
| |||
19. Since leardning I have HIV, I worry about people discriminating against me | −0.389 | 0.926 | 0.837 | |||
11. It is easier to avoid new friendship than worry about telling someone that I have HIVc
|
Phase 2. Psychometric evaluation of the short version of the HIV Stigma Scale
Construct validity
Factorsb
| ||||
---|---|---|---|---|
1 | 2 | 3 | 4 | |
Eigenvalues | 5.61 | 1.50 | 1.21 | 1.01 |
Item | ||||
Personalised stigma | ||||
29. People I care about stopped calling after learning I have HIV |
0.978
| −0.010 | −0.044 | 0.025 |
36. I have lost friends by telling them I have HIV |
0.862
| 0.005 | −0.081 | −0.093 |
28. Some people avoid touching me once they know I have HIV |
0.614
| −0.005 | 0.245 | 0.012 |
Disclosure concerns | ||||
6. I work hard to keep my HIV a secret | −0.025 |
−0.870
| −0.054 | −0.036 |
4. Telling someone I have HIV is risky | −0.017 |
−0.764
| −0.041 | −0.146 |
17. I am very careful who I tell that I have HIV | 0.005 |
−0.748
| 0.135 | 0.086 |
Concerns about public attitudes | ||||
10. Most people believe a person who has HIV is dirty | −0.023 | −0.001 |
0.783
| −0.103 |
9. People with HIV are treated like outcasts | 0.035 | 0.023 |
0.705
| −0.145 |
20. Most people are uncomfortable around someone with HIV | 0.132 | −0.260 |
0.604
| 0.094 |
Negative self-image | ||||
2. I feel guilty because I have HIV | 0.012 | −0.041 | −0.038 |
−0.759
|
3. People’s attitudes about HIV make me feel worse about myself | 0.033 | −0.046 | 0.046 |
−0.758
|
7. I feel I’m not as good a person as others because I have HIV | 0.033 | 0.008 | 0.130 |
−0.663
|
Mean item scoreb (SD) | Corrected item-total correlation | Mean subscale scorec (SD) | Reliability, α | Floor/ceiling effect (%) | |
---|---|---|---|---|---|
Personalised stigma | 6.09 (2.75) | 0.88 | 28/6 | ||
28. Some people avoid touching me once they know I have HIV | 2.06 (1.00) | 0.70 | |||
29. People I care about stopped calling after learning I have HIV | 1.97 (1.00) | 0.84 | |||
36. I have lost friends by telling them I have HIV | 2.06 (1.06) | 0.78 | |||
Disclosure concerns | 9.08 (2.57) | 0.84 | 6/22 | ||
4. Telling someone I have HIV is risky | 2.97 (0.98) | 0.68 | |||
6. I work hard to keep my HIV a secret | 2.97 (1.02) | 0.74 | |||
17. I am very careful who I tell that I have HIV | 3.25 (0.96) | 0.68 | |||
Concerns about public attitudes | 7.60 (2.50) | 0.81 | 9/9 | ||
9. People with HIV are treated like outcasts | 2.43 (0.97) | 0.67 | |||
10. Most people believe a person who has HIV is dirty | 2.54 (0.99) | 0.71 | |||
20. Most people are uncomfortable around someone with HIV | 2.64 (0.97) | 0.62 | |||
Negative self-image | 6.40 (2.75) | 0.80 | 24/5 | ||
2. I feel guilty because I have HIV | 2.21 (1.09) | 0.62 | |||
3. People’s attitudes about HIV make me feel worse about myself | 2.17 (1.07) | 0.70 | |||
7. I feel I’m not as good a person as others because I have HIV | 2.01 (1.09) | 0.62 |