Development of a scale to measure Nurses Experiences with HIV and AIDS Stigma in South Africa

Purpose: HIV /AIDS remains a major health problem in South Africa and reducing and eliminating HIV/AIDS-related stigma towards people living with HIV/AIDS (PLWHA) is essential to controlling the epidemic. The healthcare setting is usually where PLWHAs first learned about their HIV status, and nurses play a critical role in their counseling and treatment. In this study, we develop a scale to assess HIV stigma experiences among nurses who treat PLWHA South Africa. We also examine the relation between nurses' experiences with HIV and AIDS stigma in the workplace and their experiences in their communities relative to HIV/ AIDS stigma.

Methods: Measurement items were generated through a multi-phase process. This process included interviews and focus group discussions with nurses and field testing. Subsequently, purposive sampling was use to identify 395 nurses including 199 nurses in Cape Town and 196 nurses in the Limpopo Province. Factor and reliability analyses were employed to develop the final scale- Nurses Experiences with HIV/AIDS Stigma Scale (NEHS-S). Analysis of variance was used to examine the relation between NEHS-S and personal beliefs about HIV/AIDS stigma.

Results: The final NEHS-S has 7 items and acceptable reliability at α=0.07. The NEHS-S was positively related to stigmatizing behavior towards people living with HIV/AIDS (PLWHA) in the community, and negatively related to perceived responsibility as a health care provider to reduce HIV/AIDS stigma.

Implications: Measuring the experiences of nurses who care for PLWHA is a first step in guiding HIV and AIDS stigma reduction interventions in health care settings.