Background
Methods
Step 1: Translation
Step 2: Psychometric evaluation
Study design
Study population
Study instrument and measurements
Statistical analysis
Confirmatory factor analysis
Differential item functioning
Reliability
Construct validity
Results
Step 1: Translation
Item# | Original item | Final Brazilian Portuguese translation |
---|---|---|
Personalized stigma | ||
01 | People I care about stopped calling after learning I have HIV | Pessoas que eu gosto pararam de falar comigo quando souberam que eu tenho HIV |
02 | I have lost friends by telling them I have HIV | Já perdi amigos depois de contar que tenho HIV |
03 | Some people avoid touching me once they know I have HIV | Algumas pessoas evitam me tocar depois que descobrem que tenho HIV |
Disclosure concerns | ||
04 | I work hard to keep my HIV a secret | Me esforço para manter em segredo que tenho HIV |
05 | Telling someone I have HIV is risky | Tenho receio de contar para alguém que tenho HIV |
06 | I am very careful who I tell that I have HIV | Tomo muito cuidado com quem falo que tenho HIV |
Concerns about public attitudes | ||
07 | Most people believe a person who has HIV is dirty | A maioria das pessoas acredita que quem tem HIV é sujo |
08 | People with HIV are treated like outcasts | Pessoas com HIV são marginalizadas |
09 | Most people are uncomfortable around someone with HIV | A maioria das pessoas se sente desconfortável na presença de alguém com HIV |
Negative self-image | ||
10 | I feel guilty because I have HIV | Me sinto culpado por ter HIV |
11 | People’s attitudes about HIV make me feel worse about myself | As atitudes das pessoas em relação ao HIV fazem com que me sinta mal |
12 | I feel I’m not as good a person as others because I have HIV | Sinto que não sou uma pessoa tão boa quanto as outras por ter HIV |
Step 2: Psychometric evaluation
Sample characteristics
Grindr | Social media | Hornet | |
---|---|---|---|
Total | 114 | 164 | 1824 |
Age | |||
Mean (SD) | 38.6 (10.1) | 43.7 (12.3) | 37.8 (9.9) |
Age categories | |||
18–24 | 8 (7.0) | 6 (3.7) | 103 (5.6) |
25–29 | 16 (14.0) | 21 (12.8) | 301 (16.5) |
30–39 | 39 (34.2) | 38 (23.2) | 721 (39.5) |
40–49 | 33 (28.9) | 42 (25.6) | 423 (23.2) |
50–59 | 16 (14.0) | 38 (23.2) | 238 (13.0) |
60+ | 2 (1.8) | 19 (11.6) | 38 (2.1) |
Gender | |||
Cisgender men | 114 (100) | 89 (54.3) | 1794 (98.4) |
Cisgender women | 0 (0) | 63 (38.4) | 0 (0) |
Transgender/non-binary | 0 (0) | 12 (7.3) | 30 (1.6) |
Sexual orientation | |||
Gay/homosexual | 104 (91.2) | 87 (54.0) | 1665 (91.4) |
Bisexual | 10 (8.8) | 6 (3.7) | 146 (8.0) |
Heterosexual | 0 (0) | 68 (42.2) | 9 (0.5) |
Skin color/race | |||
White | 63 (56.8) | 75 (46.3) | 1121 (63.0) |
Black | 14 (12.6) | 25 (15.4) | 191 (10.7) |
Pardo (Mixed)/native | 34 (30.6) | 62 (38.3) | 467 (26.3) |
Incomea | |||
Low | 26 (22.8) | 93 (56.7) | 497 (27.2) |
Middle | 57 (50.0) | 58 (35.4) | 832 (45.6) |
High | 31 (27.2) | 13 (7.9) | 495 (27.1) |
Education (years)b | |||
≤ 12 | 30 (26.5) | 100 (61.0) | 565 (31.4) |
> 12 | 83 (73.5) | 64 (39.0) | 1233 (68.6) |
Regionc | |||
Other | 36 (31.6) | 27 (16.5) | 121 (6.6) |
Southeast/South | 78 (68.4) | 137 (83.5) | 1703 (93.4) |
Partner | |||
No | 83 (72.8) | 82 (50.0) | – |
Yes | 31 (27.2) | 82 (50.0) | – |
Short HIV Stigma Scale scores | |||
Personalized stigma | |||
Mean (SD) | 5.9 (2.9) | 5.9 (2.8) | 5.5 (2.5) |
Disclosure concerns | |||
Mean (SD) | 11.1 (1.5) | 8.9 (3.2) | 10.6 (2.1) |
Concerns about public attitudes | |||
Mean (SD) | 9.8 (1.9) | 8.7 (2.4) | 9.3 (2.2) |
Negative self-image | |||
Mean (SD) | 7.8 (2.6) | 6.7 (2.5) | 7.3 (2.6) |
Analysis 1: Grindr and social media samples
Confirmatory factor analysis
Differential item functioning
Short HIV stigma items | Analysis 1: Grindr and social media samples | Analysis 2: Hornet and social media samples | ||
---|---|---|---|---|
Base model | DIF corrected | Base model | DIF corrected | |
Personalized stigma | ||||
People I care about stopped calling after learning I have HIV | 0.896 | 0.896 | 0.854 | 0.854 |
I have lost friends by telling them I have HIV | 0.883 | 0.883 | 0.901 | 0.901 |
Some people avoid touching me once they know I have HIV | 0.853 | 0.853 | 0.860 | 0.860 |
Disclosure concerns | ||||
I work hard to keep my HIV a secret | 0.945 | 0.945 | 0.900 | 0.900 |
Telling someone I have HIV is risky | 0.946 | 0.946 | 0.955 | 0.955 |
I am very careful who I tell that I have HIV | 0.908 | 0.908 | 0.861 | 0.861 |
Concerns about public attitudes | ||||
Most people believe a person who has HIV is dirty | 0.839 | 0.839 | 0.839 | 0.839 |
People with HIV are treated like outcasts | 0.614 | 0.614 | 0.732 | 0.732 |
Most people are uncomfortable around someone with HIV | 0.745 | 0.745 | 0.813 | 0.813 |
Negative self-image | ||||
I feel guilty because I have HIV | 0.529 | 0.503 | 0.677 | 0.673 |
People’s attitudes about HIV make me feel worse about myself | 0.891 | 0.895 | 0.872 | 0.872 |
I feel I’m not as good a person as others because I have HIV | 0.662 | 0.660 | 0.670 | 0.670 |
Structural effect of group on latent factora | ||||
Personalized stigma | − 0.020 | − 0.020 | − 0.145 | − 0.145 |
Disclosure concerns | 0.969 | 0.969 | 0.647 | 0.647 |
Concerns about public attitudes | 0.487 | 0.487 | 0.243 | 0.243 |
Negative self-image | 0.252 | 0.194 | 0.180 | 0.120 |
Direct effect on item attributable to group | ||||
I feel guilty because I have HIV (item 10) | 0.298 | 0.219 |
Analysis 2: Hornet and social media samples
Confirmatory factor analysis
Differential item functioning
Reliability
Construct validity
Antiretroviral treatment usea | Adherenceb | Adherencec | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No | Yes | Test statisticd | pd | No | Yes | Test statisticd | pd | No | Yes | Test statisticd | pd | |
Grindr, N (%) | 4 (3.5) | 110 (96.5) | 39 (35.5) | 71 (64.5) | 14 (12.7) | 96 (87.3) | ||||||
Personalized stigma | 9.5 (3.0) | 5.7 (2.8) | 365 | 0.02 | 6.7 (3.0) | 5.2 (2.6) | 998 | 0.01 | 5.0 (2.3) | 5.9 (2.9) | 768 | 0.38 |
Disclosure concerns | 12.0 (0.0) | 11.1 (1.5) | 296 | 0.16 | 11.1 (1.5) | 11.1 (1.6) | 1402 | 0.90 | 11.1 (1.5) | 11.1 (1.6) | 687 | 0.87 |
Concerns about public attitudes | 11.0 (1.4) | 9.8 (1.9) | 304 | 0.19 | 10.1 (1.9) | 9.6 (2.0) | 1176 | 0.19 | 9.4 (1.6) | 9.8 (2.0) | 802 | 0.24 |
Negative self-image | 8.0 (3.7) | 7.8 (2.6) | 231 | 0.87 | 8.0 (2.4) | 7.6 (2.6) | 1286 | 0.54 | 7.3 (2.2) | 7.8 (2.6) | 757 | 0.45 |
Social media, N (%) | 6 (3.7) | 158 (96.3) | 70 (45.2) | 85 (54.8) | 20 (12.9) | 135 (87.1) | ||||||
Personalized stigma | 4.5 (2.0) | 6.0 (2.8) | 326 | 0.19 | 6.6 (3.0) | 5.6 (2.5) | 2392 | 0.03 | 8.8 (2.3) | 5.6 (2.6) | 507 | < 0.01 |
Disclosure concerns | 8.8 (3.2) | 8.9 (3.2) | 433 | 0.72 | 8.8 (3.2) | 9.1 (3.1) | 3125 | 0.58 | 9.8 (2.2) | 8.9 (3.3) | 1248 | 0.58 |
Concerns about public attitudes | 8.5 (3.4) | 8.7 (2.4) | 487 | 0.85 | 8.8 (2.5) | 8.6 (2.3) | 2705 | 0.32 | 8.9 (2.2) | 8.6 (2.4) | 1270 | 0.69 |
Negative self-image | 7.5 (3.3) | 6.6 (2.5) | 551 | 0.50 | 6.8 (2.7) | 6.6 (2.3) | 2899 | 0.78 | 7.2 (2.9) | 6.6 (2.4) | 1202 | 0.31 |
Hornet, N (%) | 78 (4.3) | 1746 (95.7) | 741 (42.4) | 1005 (57.6) | 247 (14.1) | 1499 (85.9) | ||||||
Personalized stigma | 5.4 (2.7) | 5.5 (2.5) | 0.27 | 0.79 | 5.7 (2.6) | 5.4 (2.5) | 2.36 | 0.02 | 5.9 (2.7) | 5.5 (2.5) | 2.45 | 0.01 |
Disclosure concerns | 8.4 (3.6) | 10.7 (1.9) | 9.68 | < 0.01 | 10.7 (1.9) | 10.6 (1.9) | 0.90 | 0.37 | 10.7 (1.8) | 10.7 (1.9) | 0.36 | 0.72 |
Concerns about public attitudes | 8.5 (2.6) | 9.3 (2.2) | 3.1 | < 0.01 | 9.5 (2.2) | 9.3 (2.2) | 1.93 | 0.05 | 9.7 (2.1) | 9.3 (2.2) | 2.49 | 0.01 |
Negative self-image | 6.8 (2.8) | 7.3 (2.6) | 1.49 | 0.14 | 7.6 (2.6) | 7.1 (2.5) | 4.17 | < 0.01 | 7.8 (2.7) | 7.2 (2.5) | 3.53 | < 0.01 |