期刊论文详细信息
BMC Public Health
Stigmatizing attitudes towards people living with HIV/AIDS: validation of a measurement scale
Clément Dassa1  Louise Potvin1  Alix Adrien2  Marianne Beaulieu1 
[1] Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada;Secteur Vigie et Protection, Agence de la santé et des services sociaux de Montréal, Montréal, Canada
关键词: Validation;    Scale;    HIV/AIDS;    Stigma;    Attitudes;   
Others  :  1122860
DOI  :  10.1186/1471-2458-14-1246
 received in 2014-02-28, accepted in 2014-11-12,  发布年份 2014
PDF
【 摘 要 】

Background

Although stigmatization has long been recognized as a major obstacle to HIV prevention. The lack of a valid and reliable measurement tool for stigmatization is a major gap in the research. This study aimed to: 1) develop a scale of stigmatizing attitudes towards people living with HIV (SAT-PLWHA-S) and 2) demonstrate its reliability and validity.

Methods

French and English-speaking experts (n = 21) from different professional communities (academics, practitioners) assessed the clarity and relevance of the proposed items. The psychometric properties of the SAT-PLWHA-S were assessed with a random digit dial population based telephone survey (n = 1,500) of respondents in Quebec, Canada. Analyses included exploratory and confirmatory factor analyses, correlations, multiple linear regressions, t-tests, hypothesis testing of factorial structure invariance, and Cronbach’s alpha.

Results

Confirmatory factor analysis (CFA) supported a 27-item structure with seven factors: 1) concerns about occasional encounters; 2) avoidance of personal contact; 3) responsibility and blame, 4) liberalism, 5) non-discrimination, 6) confidentiality of seropositive status, and 7) criminalization of HIV transmission. Cronbach’s alphas indicate satisfactory internal consistency. An assessment of concurrent validity using Pearson’s correlation and multiple linear regression shows that homophobia and HIV transmission knowledge are significant determinants of stigmatizing attitudes toward PLHIV. Discriminant validity (t-test) results suggest that the SAT-PLWHA-S can differentiate attitudes between different groups and indicates invariant factor structure across language.

Conclusions

The results of this study suggest that the SAT-PLWHA-S is a reliable and valid tool for measuring stigmatizing attitudes toward PLHIV and that it can contribute to a deeper understanding of HIV stigma.

【 授权许可】

   
2014 Beaulieu et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150215022743438.pdf 284KB PDF download
【 参考文献 】
  • [1]Public Health Agency of Canada: Summary; Estimates of HIV Prevalence and Incidence in Canada. Ottawa, Canada: Public Health Agency of Canada; 2012.
  • [2]Chesney MA, Smith AW: Critical delays in HIV testing and care: The potential role of stigma. Am Behav Sci 1999, 42:1162-1174.
  • [3]Herek GM, Capitanio JP, Widaman KF: Stigma, social risk, and health policy: Public attitudes toward HIV surveillance policies and the social construction of illness. Health Psychol 2003, 22:533-540.
  • [4]Klein SJ, Karchner WD, O’Connell DA: Interventions to prevent HIV-related stigma and discrimination: findings and recommendations for public health practice. J Public Health Manag Pract 2002, 8:44-54.
  • [5]Malcolm A, Aggleton P, Bronfman M, Galvao J, Mane P, Verrall J: HIV-related stigmatization and discrimination: Its forms and contexts. Critical Public Health 1998, 8:347-370.
  • [6]Owen SM: Testing for acute HIV infection; implications for treatment as prevention. Curr Opin HIV AIDS 2012, 7:125-130.
  • [7]Brogly SB, Bruneau J, Lamothe F, Vincelette J, Franco EL: HIV-positive notification and behavior changes in Montreal injection drug users. AIDS Educ Prev 2002, 14:17-28.
  • [8]Celentano DD, Galai N, Sethi AK, Shah NG, Strathdee SA, Vlahov D, Gallant JE: Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users. AIDS 2001, 15:1707-1715.
  • [9]Desenclos JC, Papaevangelou G, Ancelle-Park R: Knowledge of HIV serostatus and preventive behaviour among European injecting drug users. AIDS 1993, 7:1371-1377.
  • [10]Gorbach PM, Drumright LN, Daar ES, Little SJ: Transmission behaviors of recently HIV infected men who have sex with men. J Acquir Immune Defic Syndr 2006, 42:80-85.
  • [11]Holtgrave DR, Pinkerton PD: Can increasing awareness of HIV seropositivity reduce infections by 50% in the United States? J Acquir Immune Defic Syndr 2007, 44:360-363.
  • [12]Inciardi JA, Surratt HL, Kurtz SP, Weaver JC: The effect of serostatus on HIV risk behaviour change among women sex workers in Miami, Florida. AIDS Care 2005, 17:S88-S101.
  • [13]Marks G, Crepaz N, Senterfitt JW, Janssen RS: Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: Implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005, 39:446-453.
  • [14]Schlumberger MG, Desenclos J-C, Papaevangelou G, Richardson SC, Ancelle-Park R: Knowledge of HIV serostatus and preventive behaviour among European injecting drug users: Second study. Eur J Epidemiol 1999, 15:207-215.
  • [15]Weinhardt LS, Carey MP, Johnson BT, Bickham NL: Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997. Am J Public Health 1999, 89:1397-1405.
  • [16]Wolitski RJ, MacGowan RJ, Higgins DL, Jorgensen CM: The effects of HIV counseling and testing on risk-related practices and help-seeking behavior. AIDS Education & Prevention 1997, 9:52-67.
  • [17]Bartlett JA, DeMasi R, Quinn J, Moxham C, Rousseau F: Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults. AIDS 2001, 15:1369-1377.
  • [18]Cu-Uvin S, Caliendo AM, Reinert S, Chang A, Juliano-Remollino C, Flanigan TP, Mayer KH, Carpenter CCJ: Effect of highly active antiretroviral therapy on cervicovaginal HIV-1 RNA. AIDS 2000, 14:415-421.
  • [19]Graham SM, Holte SE, Peshu NM, Richardson BA, Panteleeff DD, Jaoko WG, Ndinya-Achola JO, Mandaliya KN, Overbaugh JM, McClelland RS: Initiation of antiretroviral therapy leads to a rapid decline in cervical and vaginal HIV-1 shedding. AIDS 2007, 21:501-507.
  • [20]Gulick RM, Meibohm A, Havlir D, Eron JJ, Mosley A, Chodakewitz JA, Isaacs R, Gonzalez C, McMahon D, Richman DD, Robertson M, Mellors JW: Six-year follow-up of HIV-1-infected adults in a clinical trial of antiretroviral therapy with indinavir, zidovudine, and lamivudine. AIDS 2003, 17:2345-2349.
  • [21]Porco TC, Martin JN, Page-Shafer KA, Cheng A, Charlebois E, Grant RM, Osmond DH: Decline in HIV infectivity following the introduction of highly active antiretroviral therapy. AIDS 2004, 18:81-88.
  • [22]Castilla J, del Romero J, Hernando V, Marincovich B, Garcia S, Rodriguez C: Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV. J Acquir Immune Defic Syndr 2005, 40:96-101.
  • [23]Quinn TC, Wawer MJ, Sewankambo N, Serwadda D, Li C, Wabwire-Mangen F, Meehan MO, Lutalo T, Gray RH: Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med 2000, 342:921-929.
  • [24]Vernazza PL, Troiani L, Flepp MJ, Cone RW, Schock J, Roth F, Boggian K, Cohen MS, Fiscus SA, Eron JJ: Potent antiretroviral treatment of HIV-infection results in suppression of the seminal shedding of HIV. The Swiss HIV Cohort Study AIDS 2000, 14:117-121.
  • [25]Aggleton P: Barcelona 2002: Law, ethics, and human rights. HIV/AIDS-related stigma and discrimination: A conceptual framework. Canadian HIV-AIDS Policy Law Review 2002, 7:115-116.
  • [26]Aggleton P, Wood K, Malcolm A, Parker R: HIV-related stigma, discrimination and human rights violations: case studies of successful programmes. Geneva: Switzerland, Joint United Nations programme on HIV/AIDS; 2005.
  • [27]Aggleton P, Parker R: World AIDS Campaign 2002–2003: A conceptual framework and basis for action: HIV/AIDS stigma and discrimination. Geneva: Switzerland, UNAIDS; 2002.
  • [28]DesJarlais DC, Galea S, Tracy M, Tross S, Vlahov D: Stigmatization of newly emerging infectious diseases: AIDS and SARS. Am J Public Health 2006, 96:561-567.
  • [29]Stall R, Hoff C, Coates TJ, Paul J, Phillips KA, Ekstrand M, Diaz R: Decisions to get HIV tested and to accept antiretroviral therapies among gay/bisexual men: Implications for secondary prevention efforts. J Acquir Immune Defic Syndr Hum Retrovirol 1996, 11:151-160.
  • [30]Young SD, Bendavid E: The relationship between HIV testing, stigma, and health services usage. AIDS Care 2010, 22:373-380.
  • [31]Young SD, Monin B, Owens D: Opt-out testing for stigmatized diseases: a social psychological approach to understanding the potential effect of recommendations for routine HIV testing. Health Psychol 2009, 28:675-681.
  • [32]Novick A, Stigma and AIDS: Three layers of damage. J Gay Lesbian Med Assoc 1997, 1:53-60.
  • [33]Goffman E: Stigma: Notes on the Management of Spoiled Identity. New York: Prentice Hall; 1963.
  • [34]Dovidio JF, Major B, Crocker J: Stigma: introduction and Overview. In The Social Psychology of Stigma. Edited by Heatherton TF, Kleck RE, Hebl MR, Hull JG. New York: Guilford Publications; 2000:1-28.
  • [35]Earnshaw VA, Chaudoir SR: From conceptualizing to measuring HIV stigma: A review of HIV stigma mechanism measures. AIDS Behav 2009, 13:1160-1177.
  • [36]Fiske ST: Stereotyping, prejudice, and discrimination. In The Handbook of Social Psychology. Edited by Gilbert DT, Fiske ST. Boston, MA: McGraw Hill; 1998:357-411.
  • [37]Ottati V, Bodenhausen GV, Newman LS: Social psychological models of mental illness stigma. In On the stigma of mental illness: practical strategies for research and social change. Edited by Corrigan PW. Washington: American Psychological Association; 2005:99-128.
  • [38]Rüsch N, Angermeyer MC, Corrigan PW: Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 2005, 20:529-539.
  • [39]Earnshaw VA, Kalichman S: Stigma experienced by people living with HIV/AIDS. In Stigma, discrimination, and living with HIV/AIDS: A cross-cultural perspective. Edited by Liamputtong P. New York, NY: Springer; 2013.
  • [40]Adrien A, Beaulieu M, Leaune V, Perron M, Dassa C: Trends in attitudes toward people living with HIV, homophobia, and HIV transmission knowledge in Quebec, Canada (1996, 2002, and 2010). AIDS Care 2013, 25:55-65.
  • [41]Dijker AJ, Koomen W: Extending Weiner’s attribution-emotion model of stigmatization of ill persons. Basic Appl Soc Psychol 2003, 25:51-68.
  • [42]EKOS: HIV/AIDS Attitudinal Tracking Survey 2006: Final Report. Toronto: ON, EKOS Research Associates; 2006.
  • [43]Green G: Attitudes towards people with HIV: Are they as stigmatizing as people with HIV perceive them to be. Soc Sci Med 1995, 41:557-568.
  • [44]Herek GM: AIDS and stigma. Am Behav Sci 1999, 42:1106-1116.
  • [45]Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, Kagee A: Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav 2005, 9:135-143.
  • [46]Lau JTF, Tsui HY, Chan K: Reducing discriminatory attitudes toward people living with HIV/AIDS (PLWHA) in Hong Kong: An intervention study using an integrated knowledge-based PLWHA participation and cognitive approach. AIDS Care 2005, 17:85-101.
  • [47]Rutledge SE, Abell N: Awareness, acceptance, and action: An emerging framework for understanding AIDS stigmatizing attitudes among community leaders in Barbados. AIDS Patient Care STDS 2005, 19:186-199.
  • [48]Visser MJ, Kershaw T, Makin JD, Forsyth BW: Development of parallel scales to measure HIV-related stigma. AIDS Behav 2008, 12:759-771.
  • [49]Public Health Agency of Canada: HIV and AIDS in Canada: Surveillance Report to June 30, 2006. Ottawa, ON: Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada; 2006.
  • [50]de Bruyn T: Aids and discrimination: A Discussion Paper. Montreal: Canadian HIV/AIDS Legal Network and Canadian AIDS Society; 1998.
  • [51]Herek GM: Thinking about AIDS and stigma: A psychologist’s perspective. J Law Med Ethics 2002, 30:594-607.
  • [52]Herek G, Capitanio JP: AIDS stigma and sexual prejudice. Am Behav Sci 1999, 42:1130-1147.
  • [53]Nyblade LC: Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med 2006, 11:335-345.
  • [54]Herek GM: Illness, stigma, and AIDS. In Psychological aspects of serious illness. Edited by Costa P, VandenBos GR. Washington, DC: American Psychological Association; 1990:103-150.
  • [55]Obermeyer CM, Osborn M: The utilization of testing and counseling for HIV: A review of the social and behavioral evidence. Am J Public Health 2007, 97:1762-1774.
  • [56]Grossman CI, Stangl AL: Global action to reduce HIV stigma and discrimination. J Int AIDS Soc 2013, 16:18881.
  • [57]Sengupta S, Banks B, Jonas D, Miles MS, Smith GC: HIV interventions to reduce HIV/AIDS stigma: a systematic review. AIDS Behav 2011, 15:1075-1087.
  • [58]Stangl AL, Lloyd JK, Brady LM, Holland CE, Baral S: A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come? J Int AIDS Soc 2013, 16:18734.
  • [59]Bresnahan M, Zhuang J: Exploration and Validation of the Dimensions of Stigma. J Health Psychol 2011, 16:421-429.
  • [60]Herek GM, Glunt EK: AIDS-related attitudes in the United States: A preliminary conceptualization. The Journal of Sex Research 1991, 28:99-123.
  • [61]Herek GM, Capitanio JP, Widaman KF: HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991-1999. Am J Public Health 2002, 92:371-377.
  • [62]Galletly C, Pinkerton SD: Conflicting messages: how criminal HIV disclosure laws undermine public health efforts to control the spread of HIV. AIDS Behav 2006, 10:451-461.
  • [63]Symington A: Criminalization confusion and concerns: the decade since the Cuerrier decision. HIV/AIDS Policy and Law Review 2009, 14:5-10.
  • [64]Crocker L, Algina J: Introduction to classical and modern test theory. Pacific Grove, CA: Wadsworth; 2006.
  • [65]Benson J, Clark F: A guide for instrument development and validation. Am J Occup Ther 1982, 36:789-799.
  • [66]Herek GM: Heterosexuals’ attitudes toward lesbians and gay men: Correlates and gender differences. J Sex Res 1988, 25:451-477.
  • [67]Gerbing DW, Hamilton JG: Viability of exploratory factor analysis as a precursor to confirmatory factor analysis. Struct Equ Model 1996, 3:62.
  • [68]Jöreskog K, Sörbom D: LISREL 8: User’s Reference Guide. 2nd edition. Lincolnwood, IL: Scientific Software International, Inc; 2001.
  • [69]Gerbing DW, Anderson JC: Effects of sampling error and model characteristics on parameter estimation for maximum likelihood confirmatory factor analysis. Multivar Behav Res 1985, 20:255-271.
  • [70]Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model 1999, 6:1-55.
  • [71]Bentler PM: Some contributions to efficient statistics in structural models: Specification and estimation of moment structures. Psychometrika 1983, 48:493-517.
  • [72]De Vellis R: Scale Development: Applications and Theory. Newbury Park, CA: Sage; 1991.
  • [73]Ullman JB: Structural equation modeling. In Using multivariate statistics. Edited by Tabachnick BG, Fidell LS. Boston, MA: Allyn & Bacon; 2006:653-771.
  • [74]Chen FF: Sensitivity of goodness of fit indexes to lack of measurement invariance. Struct Equ Model 2007, 14:464-504.
  • [75]Allport GW: The nature of prejudice. Reading, MA: Addison-Wesley; 1954.
  • [76]Genberg BL, Kawichai S, Chingono A, Sendah M, Chariyalertsak S, Konda KA, Celentano DD: Assessing HIV/AIDS stigma and discrimination in developing countries. AIDS Behav 2008, 12:772-780.
  • [77]Pescosolido BA, Martin JK, Lang A, Olafsdottir S: Rethinking theoretical approaches to stigma: A Framework Integrating Normative Influences on Stigma (FINIS). Soc Sci Med 2008, 67:431-440.
  • [78]Herek GM, Capitanio JP: Public reactions to AIDS in the United States: a second decade of stigma. Am J Public Health 1993, 83:574-577.
  • [79]Herek GM, Capitanio JP: AIDS stigma and contact with persons with AIDS: Effects of direct and vicarious contact. J Appl Soc Psychol 1997, 27:1-36.
  • [80]Kempf AM, Remington PL: New challenges for telephone survey research in the twenty-first century. Annu Rev Public Health 2007, 28:113-126.
  • [81]Edwards AL: The social desirability variable in personality assessment and research. New York: Dryden; 1957.
  • [82]Reidpath DD, Chan KY: A method for the quantitative analysis of the layering of HIV-related stigma. AIDS Care 2005, 17:425-432.
  文献评价指标  
  下载次数:3次 浏览次数:8次