A Psychometric Evaluation and a Framework Test of the HIV Stigma Mechanisms Scale Among a Population-Based Sample of Men and Women Living with HIV in Central Uganda

Alexandra Almeida, Ijeoma Nwabuzor Ogbonnaya, Rhoda K. Wanyenze, Katherine Schmarje Crockett, Michael Ediau, Rose Naigino, Chii Dean Lin, Susan M. Kiene

Research output: Contribution to journalArticlepeer-review

Abstract

HIV stigma is a critical barrier to HIV prevention and care. This study evaluates the psychometric properties of the HIV Stigma Mechanisms Scale (HIV-SMS) among people living with HIV (PLHIV) in central Uganda and tests the underlying framework. Using data from the PATH/Ekkubo study, (n = 804 PLHIV), we assessed the HIV-SMS’ reliability and validity (face, content, construct, and convergent). We used multiple regression analyses to test the HIV-SMS’ association with health and well-being outcomes. Findings revealed a more specific (5-factor) stigma structure than the original model, splitting anticipated and enacted stigmas into two subconstructs: family and healthcare workers (HW). The 5-factor model had high reliability (α = 0.92–0.98) and supported the convergent validity (r = 0.12–0.42, p < 0.01). The expected relationship between HIV stigma mechanisms and health outcomes was particularly strong for internalized stigma. Anticipated-family and enacted-family stigma mechanisms showed partial agreement with the hypothesized health outcomes. Anticipated-HW and enacted-HW mechanisms showed no significant association with health outcomes. The 5-factor HIV-SMS yielded a proper and nuanced measurement of HIV stigma in central Uganda, reflecting the importance of family-related stigma mechanisms and showing associations with health outcomes similar to and beyond the seminal study.

Original languageEnglish (US)
Pages (from-to)3038-3052
Number of pages15
JournalAIDS and Behavior
Volume27
Issue number9
DOIs
StatePublished - Sep 2023

Keywords

  • HIV
  • Scale
  • Stigma
  • Sub-Saharan Africa
  • Uganda

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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