Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

Division of General Internal Medicine and Health Services Research, UCLA, 911 Broxton Ave., Los Angeles, CA 90024, USA.
AIDS and Behavior (Impact Factor: 3.49). 05/2008; 12(5):748-58. DOI: 10.1007/s10461-008-9375-3
Source: PubMed


There is a need for a psychometrically sound measure of the stigma experienced by diverse persons living with HIV/AIDS (PLHA). The goal of this study was to develop and evaluate a multidimentional measure of internalized HIV stigma that captures stigma related to treatment and other aspects of the disease among sociodemographically diverse PLHA. We developed a 28-item measure of internalized HIV stigma composed of four scales based on previous qualitative work. Internal consistency reliability estimates in a sample of 202 PLHA was 0.93 for the overall measure, and exceeded 0.85 for three of the four stigma scales. Items discriminated well across scales, and correlations of the scales with shame, social support, and mental health supported construct validity. This measure should prove useful to investigators examining in the role of stigma in HIV treatment and health outcomes, and evaluating interventions designed to mitigate the impacts of stigma on PLHA.

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    • "ternalized stigma and a desire to save face sometimes interfered with patient - provider relationships . Although our sample size was too small to allow robust analysis of HIV stigma scale structural validity in this population ( using structural equation modeling ) , reliability estimates were comparable to those obtained for the original scale ( Sayles et al . , 2008 ) . Given the cross - sectional design , we were unable to assess causal relationships between HIV stigma , health behaviors , and clinical outcomes . Finally , we did not examine sexual or ethnic minority status as potentially important types of intersecting stigma ."
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