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Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context

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  • Maria H Lindberg
  • Lena Wettergren
  • Maria Wiklander
  • Veronica Svedhem-Johansson
  • Lars E Eriksson

Abstract

Background: HIV-related stigma has negative consequences for infected people's lives and is a barrier to HIV prevention. Therefore valid and reliable instruments to measure stigma are needed to enable mapping of HIV stigma. This study aimed to evaluate the psychometric properties of the HIV stigma scale in a Swedish context with regard to construct validity, data quality, and reliability. Methods: The HIV stigma scale, developed by Berger, Ferrans, and Lashley (2001), was distributed to a cross-sectional sample of people living with HIV in Sweden (n = 194). The psychometric evaluation included exploratory factor analysis together with an analysis of the distribution of scores, convergent validity by correlations between the HIV stigma scale and measures of emotional well-being, and an analysis of missing items and floor and ceiling effects. Reliability was assessed using Cronbach's α. Results: The exploratory factor analysis suggested a four-factor solution, similar to the original scale, with the dimensions personalised stigma, disclosure concerns, negative self-image, and concerns with public attitudes. One item had unacceptably low loadings and was excluded. Correlations between stigma dimensions and emotional well-being were all in the expected direction and ranged between −0.494 and −0.210. The instrument generated data of acceptable quality except for participants who had not disclosed their HIV status to anybody. In line with the original scale, all subscales demonstrated acceptable internal consistency with Cronbach's α 0.87–0.96. Conclusion: A 39-item version of the HIV stigma scale used in a Swedish context showed satisfactory construct validity and reliability. Response alternatives are suggested to be slightly revised for items assuming the disclosure of diagnosis to another person. We recommend that people that have not disclosed should skip all questions belonging to the dimension personalised stigma. Our analysis confirmed construct validity of the instrument even without this dimension.

Suggested Citation

  • Maria H Lindberg & Lena Wettergren & Maria Wiklander & Veronica Svedhem-Johansson & Lars E Eriksson, 2014. "Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-16, December.
    • Handle: RePEc:plo:pone00:0114867
    DOI: 10.1371/journal.pone.0114867
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    References listed on IDEAS

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    1. John Horn, 1965. "A rationale and test for the number of factors in factor analysis," Psychometrika, Springer;The Psychometric Society, vol. 30(2), pages 179-185, June.
    2. Parker, Richard & Aggleton, Peter, 2003. "HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action," Social Science & Medicine, Elsevier, vol. 57(1), pages 13-24, July.
    3. Fortenberry, J.D. & McFarlane, M. & Bleakley, A. & Bull, S. & Fishbein, M. & Grimley, D.M. & Malotte, C.K. & Stoner, B.P., 2002. "Relationships of stigma and shame to gonorrhea and HIV screening," American Journal of Public Health, American Public Health Association, vol. 92(3), pages 378-381.
    4. Steward, Wayne T. & Herek, Gregory M. & Ramakrishna, Jayashree & Bharat, Shalini & Chandy, Sara & Wrubel, Judith & Ekstrand, Maria L., 2008. "HIV-related stigma: Adapting a theoretical framework for use in India," Social Science & Medicine, Elsevier, vol. 67(8), pages 1225-1235, October.
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    1. Chen Zhang & Xiaoming Li & Yu Liu & Shan Qiao & Liying Zhang & Yuejiao Zhou & Zhenzhu Tang & Zhiyong Shen & Yi Chen, 2016. "Stigma against People Living with HIV/AIDS in China: Does the Route of Infection Matter?," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-15, March.
    2. Stanley W. Wanjala & Ezra K. Too & Stanley Luchters & Amina Abubakar, 2021. "Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review," IJERPH, MDPI, vol. 18(24), pages 1-29, December.
    3. Nella Otoobea Anakwa & Enoch Teye-Kwadjo & Irene A. Kretchy, 2021. "Effect of HIV-Related Stigma and HIV-Related Stress on HIV Disclosure Concerns: a Study of HIV-Positive Persons on Antiretroviral Therapy at Two Urban Hospitals in Ghana," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 16(3), pages 1249-1264, June.

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