Extending a 20-item HIV stigma scale suite among at-risk youths in South Africa: An examination of reliability and validity

Purpose: This study extended a validated scale suite on HIV perceived stigma, discrimination, and disclosure concerns, originally developed and tested among people living with HIV/AIDS (PLWHA) and young adults in the U.S., to at risk youths in South Africa. METHODS: Hou’s previously validated 20-item HIV-stigma scale with items measuring perceived stigma towards PLWHA (7-item), discrimination (5-item), and disclosure concerns (8-item) was used.  Measurement items were examined by researchers and local HIV practitioners to ensure content validity and cultural relevancy.  At-risk youths from a camp-based HIV prevention program participated in the study.   RESULTS: A total of 385 youths participated (age ranged 10-24 years; 55% females).  Data showed satisfactory internal consistencies on all three sub-scales, with Cronbach alphas of .826, .804, and .700 (CITC ranged .300~.666) for the perceived stigma, discrimination, and disclosure concerns, respectively.  Overall perceived stigma towards PLWHA were higher among youths in South Africa compared with the original pilot-tested U.S. sample of young adults (scale means: 14.16 vs. 9.94).  Perceived discrimination was the highest in the U.S. sample of PLWHA, followed by youths in South Africa, and lowest in the U.S. young adult sample (scale means: 14.53, 8.07, and 5.54, respectively).  On the other hand, disclosure concerns were lowest among South Africa youths compared with the U.S. samples of PLWHA and young adults (scale means: 19.77, 24.82, and 25.27, respectively).  CONCLUSIONS: Results indicate all sub-scales demonstrated satisfactory validities and reliabilities among at-risk youths in South Africa.  This validated measurement tool provides new opportunities for researchers and practitioners to assess and compare HIV related stigma for program planning and evaluation purposes.