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López A, Rafful C, Orozco R, Contreras-Valdez JA, Jiménez-Rivagorza L, Morales M. HIV Stigma Mechanisms Scale: Factor Structure, Reliability, and Validity in Mexican Adults. AIDS Behav 2023; 27:1321-1328. [PMID: 36287344 PMCID: PMC9607813 DOI: 10.1007/s10461-022-03868-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/25/2022]
Abstract
We aimed to validate the HIV Stigma Mechanisms Scale (HIV-SMS) in a sample of Mexican adults living with HIV, which differentiates between sources and mechanisms of stigma. Adults (n = 362) with a median age of 32 years old completed a web-based version in Spanish of the HIV-SMS as well as sociodemographic and HIV-related characteristics questionnaire. Exploratory factor analyses with weighted least squares and oblique rotation were performed to assess the construct validity of the scale. The Spanish translation for the Mexican population of the HIV-SMS has adequate internal consistency (Ω = 0.86) and demonstrated a structure similar to the original scale. After excluding the items related to community and social workers, a five-factor solution with internalized, promulgated, and anticipated stigma from family and healthcare workers showed adequate construct validity. The HIV-SMS is a valid and sensitive scale that can be used in a Mexican adult population living with HIV.
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Affiliation(s)
- Andrea López
- Faculty of Psychology, Universidad Nacional Autónoma de México, Circuito Ciudad Universitaria, 04510, Mexico City, Mexico
| | - Claudia Rafful
- Faculty of Psychology, Universidad Nacional Autónoma de México, Circuito Ciudad Universitaria, 04510, Mexico City, Mexico.
- Center for Global Mental Health, National Institute of Psychiatry, Coyoacan, Mexico City, Mexico.
| | - Ricardo Orozco
- Center for Global Mental Health, National Institute of Psychiatry, Coyoacan, Mexico City, Mexico
| | - José Alfredo Contreras-Valdez
- Faculty of Psychology, Universidad Nacional Autónoma de México, Circuito Ciudad Universitaria, 04510, Mexico City, Mexico
| | - Leonardo Jiménez-Rivagorza
- Faculty of Psychology, Universidad Nacional Autónoma de México, Circuito Ciudad Universitaria, 04510, Mexico City, Mexico
| | - Missael Morales
- Faculty of Psychology, Universidad Nacional Autónoma de México, Circuito Ciudad Universitaria, 04510, Mexico City, Mexico
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Massaroni V, Delle Donne V, Ciccarelli N, Lombardi F, Lamonica S, Borghetti A, Ciccullo A, Di Giambenedetto S. HIV-Related Internalized Stigma and Patient Health Engagement Model in an Italian Cohort of People Living With HIV. Psychol Rep 2022; 126:1181-1200. [PMID: 35015591 DOI: 10.1177/00332941211057142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The care engagement of people living with HIV (PLWH) measured with the patient health engagement (PHE) model and its association with HIV-related internalized stigma are not well established. Indeed, currently there are no data yet about the engagement of PLWH measured with the PHE model. This study aimed to evaluate the effects of HIV-related internalized stigma on care engagement and mental health and to fill the lack of data on PHE model applied to PLWH. We found that the internalized stigma score was significantly higher for PLWH (n=82) in worse care engagement phase and both higher internalized stigma scores and worse engagement were associated to major depression symptoms.In conclusion, our findings describe for the first time the engagement in care of PLWH measured with PHE and highlight the importance of PLWH support to find strategies to cope stigma-related stress and optimize their care engagement.
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Affiliation(s)
- Valentina Massaroni
- Infectious Diseases Institute, Department of Safety and Bioethics, 60234Catholic University of Sacred Heart, Rome, Italy
| | - Valentina Delle Donne
- Infectious Diseases Institute, Department of Safety and Bioethics, 60234Catholic University of Sacred Heart, Rome, Italy
| | | | - Francesca Lombardi
- UOC Infectious Diseases, 18654Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Lamonica
- UOC Infectious Diseases, 18654Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alberto Borghetti
- UOC Infectious Diseases, 18654Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Simona Di Giambenedetto
- Infectious Diseases Institute, Department of Safety and Bioethics, 60234Catholic University of Sacred Heart, Rome, Italy.,UOC Infectious Diseases, 18654Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Wanjala SW, Too EK, Luchters S, Abubakar A. Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13074. [PMID: 34948690 PMCID: PMC8701211 DOI: 10.3390/ijerph182413074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
Addressing HIV-related stigma requires the use of psychometrically sound measures. However, despite the Berger HIV stigma scale (HSS) being among the most widely used measures for assessing HIV-related stigma, no study has systematically summarised its psychometric properties. This review investigated the psychometric properties of the HSS. A systematic review of articles published between 2001 and August 2021 was undertaken (CRD42020220305) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we searched the grey literature and screened the reference lists of the included studies. Of the total 1241 studies that were screened, 166 were included in the review, of which 24 were development and/or validation studies. The rest were observational or experimental studies. All the studies except two reported some aspect of the scale's reliability. The reported internal consistency ranged from acceptable to excellent (Cronbach's alpha ≥ 0.70) in 93.2% of the studies. Only eight studies reported test-retest reliability, and the reported reliability was adequate, except for one study. Only 36 studies assessed and established the HSS's validity. The HSS appears to be a reliable and valid measure of HIV-related stigma. However, the validity evidence came from only 36 studies, most of which were conducted in North America and Europe. Consequently, more validation work is necessary for more precise insights.
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Affiliation(s)
- Stanley W. Wanjala
- Department of Public Health and Primary Care, Campus UZ-Ghent, Ghent University, 9000 Ghent, Belgium
- Department of Social Sciences, Pwani University, Kilifi P.O. Box 195-80108, Kenya
| | - Ezra K. Too
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
| | - Stanley Luchters
- Department of Public Health and Primary Care, Campus UZ-Ghent, Ghent University, 9000 Ghent, Belgium
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya; (E.K.T.); (A.A.)
- Department of Public Health, Pwani University, Kilifi P.O. Box 195-80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Neuroassessment Group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kilifi P.O. Box 230-80108, Kenya
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HIV Stigma and Moral Judgement: Qualitative Exploration of the Experiences of HIV Stigma and Discrimination among Married Men Living with HIV in Yogyakarta. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020636. [PMID: 31963807 PMCID: PMC7013688 DOI: 10.3390/ijerph17020636] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 12/14/2022]
Abstract
It is well acknowledged that human immunodeficiency virus stigma (HIV stigma) challenges people living with HIV globally. There is a scarcity of information about determinants of HIV stigma and discrimination among married men in the Indonesian context. This study aimed to explore factors that contribute to stigma and discrimination against HIV-positive men married to women in Yogyakarta, Indonesia. Face-to-face in-depth interviews were conducted to collect data from participants using a snowball sampling technique. A framework analysis was used to guide the analysis of the data. HIV stigma framework was also applied in the conceptualisation and the discussion of the findings. The findings indicate that participants experienced external stigma within healthcare facilities, communities and families. This external stigma was expressed in various discriminatory attitudes and behaviours by healthcare professionals and community and family members. Similarly, participants experienced anticipated stigma as a result of HIV stigma and discrimination experienced by other people living with HIV. Individual moral judgement associating HIV status with amoral behaviours and participants' negative self-judgement were determinants of perceived stigma. The current findings indicate the need for training programs about HIV stigma issues for healthcare professionals. There is also a need to disseminate HIV information and to improve HIV stigma knowledge among families and communities.
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Kagiura F, Fujii T, Kihana N, Maruyama E, Shimoji Y, Kakehashi M. Brief HIV stigma scale for Japanese people living with HIV: validation and restructuring using questionnaire survey data. AIDS Care 2019; 32:1-9. [PMID: 31658827 DOI: 10.1080/09540121.2019.1683809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed of validating a ten-item HIV stigma scale that was originally developed in the U.S.A. and adapting it for Japanese adults with HIV. To adapt the HIV stigma scale for Japanese adults with HIV, a forward-backward translation method was employed. We assessed its validity and reliability using questionnaire survey data collected from 463 Japanese adults with HIV between August 2017 and February 2018. Although the validity was acceptable, the internal consistency in two subcategories in the Japanese version of the HIV stigma scale was low (ω: 0.63, 0.60). Therefore, we performed exploratory factor analysis, which suggested a different model consisting of two subcategories. Then, we assessed the reliability and validity of the scale. The omega values were between 0.83 and 0.89, the absolute correlations (|r|) to other psychological scales for external validity were between 0.34 and 0.51, and the non-response rates for feasibility were between 0.9 and 1.8. The Japanese version of the HIV stigma scale therefore had sufficient reliability and validity. This questionnaire may help identify individuals that need increased care, which may improve their quality of life.
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Affiliation(s)
- Fumiko Kagiura
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
| | - Teruhisa Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima City, Japan
| | - Nobuko Kihana
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima City, Japan
| | - Eiko Maruyama
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima City, Japan
| | - Yuka Shimoji
- Nursing Department, National Hospital Organization Osaka Medical Center, Osaka City, Japan
| | - Masayuki Kakehashi
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
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Chaillon A, Avila-Ríos S, Wertheim JO, Dennis A, García-Morales C, Tapia-Trejo D, Mejía-Villatoro C, Pascale JM, Porras-Cortés G, Quant-Durán CJ, Lorenzana I, Meza RI, Palou EY, Manzanero M, Cedillos RA, Reyes-Terán G, Mehta SR. Identification of major routes of HIV transmission throughout Mesoamerica. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2017; 54:98-107. [PMID: 28645708 PMCID: PMC5610625 DOI: 10.1016/j.meegid.2017.06.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/13/2017] [Accepted: 06/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Migration and travel are major drivers of the spread of infectious diseases. Geographic proximity and a common language facilitate travel and migration in Mesoamerica, which in turn could affect the spread of HIV in the region. METHODS 6092 HIV-1 subtype B partial pol sequences sampled from unique antiretroviral treatment-naïve individuals from Mexico (40.7%), Guatemala (24.4%), Honduras (19%), Panama (8.2%), Nicaragua (5.5%), Belize (1.4%), and El Salvador (0.7%) between 2011 and 2016 were included. Phylogenetic and genetic network analyses were performed to infer putative relationships between HIV sequences. The demographic and geographic associations with clustering were analyzed and viral migration patterns were inferred using the Slatkin-Maddison approach on 100 iterations of random subsets of equal number of sequences per location. RESULTS A total of 1685/6088 (27.7%) of sequences linked with at least one other sequence, forming 603 putative transmission clusters (range: 2-89 individuals). Clustering individuals were significantly more likely to be younger (median age 29 vs 33years, p<0.01) and men-who-have-sex-with-men (40.4% vs 30.3%, p<0.01). Of the 603 clusters, 30 (5%) included sequences from multiple countries with commonly observed linkages between Mexican and Honduran sequences. Eight of the 603 clusters included >10 individuals, including two comprised exclusively of Guatemalans (52 and 89 individuals). Phylogenetic and migration analyses suggested that the Central and Southern regions of Mexico along with Belize were major sources of HIV throughout the region (p<0.01) with genetic flow southward from Mexico to the other nations of Mesoamerica. We also found evidence of significant viral migration within Mexico. CONCLUSION International clusters were infrequent, suggesting moderate migration between HIV epidemics of the different Mesoamerican countries. Nevertheless, we observed important sources of transnational HIV spread in the region, including Southern and Central Mexico and Belize.
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Affiliation(s)
| | - Santiago Avila-Ríos
- Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | | | - Ann Dennis
- University of North Carolina, Chapel Hill, NC, USA
| | - Claudia García-Morales
- Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - Daniela Tapia-Trejo
- Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | | | - Juan M Pascale
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | | | | | - Ivette Lorenzana
- National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Rita I Meza
- Honduras National Reference HIV Laboratory, Tegucigalpa, Honduras
| | - Elsa Y Palou
- University School Hospital, Tegucigalpa, Honduras
| | | | | | - Gustavo Reyes-Terán
- Center for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
| | - Sanjay R Mehta
- University of California, San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
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