181810 Psychometric assessment of HIV-related stigma indicators using two studies in Malawi

Wednesday, October 29, 2008

Alisha H. Creel, PhD , Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
Kirsten Böse, MHS , Center for Communication Programs, Johns Hopkins University, Baltimore, MD
Glory Mkandawire , Malawi BRIDGE Project, Lilongwe, Malawi
Lisa K. Folda, MHS , Johns Hopkins University Center for Communication Programs, Baltimore, MD
Jane W. Brown, MPH , Johns Hopkins University Center for Communication Programs, Baltimore, MD
Rajiv N. Rimal, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Finding reliable, valid, and standard indicators of HIV-related stigma in the general population has remained a challenge in evaluating anti-stigma interventions and comparing levels of stigma across contexts. This study looked at the psychometric properties of four indicators of stigma developed from recommendations by Nyblade and MacQuarrie (2006) -- fear of casual contact with people living with HIV/AIDS, hypothetical disclosure of HIV status, blame and judgment, and shame related to HIV. Methods: Measures were obtained from two data sources in Malawi: interviews from 300 participants of a randomized evaluation of a radio program and 966 participants of a population-based household survey. Results: Scales assessing fear of casual contact, shame and disclosure showed insufficient normality to be used as continuous measures, as a large percentage of participants reported no fear of casual contact, no shame related to HIV, or full intention to disclose HIV status on all items. Blame/judgment related to HIV showed the most variance. All scales showed good internal consistency: fear of casual contact (α=.88-.89), disclosure (α=.75), shame (α=.84-.88), and blame (α=.51-.69). Conclusions: Improving the psychometric properties of HIV-related stigma indicators remains an important priority for measuring stigma sensitively and for understanding the relationship between different dimensions of stigma. Advanced statistical techniques for theory-testing require measures with more variance and greater normality.

Learning Objectives:
Evaluate the psychometric properties of stigma indicators. Discuss ways to improve current indicators and develop new ones.

Keywords: HIV/AIDS, Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed and conducted one of the studies and consulted on the second study; I analyzed the data from both studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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