HIV Stigma Scale: Translation and Validation of the Short Version to the Portuguese Population
DOI:
https://doi.org/10.17575/psicologia.1729Keywords:
HIV/Aids, Stigma, Psychometric properties, PortugalAbstract
The objective was to translate, adapt, and analyze the psychometric properties of a shortened version of the HIV Stigma Scale using a sample of 100 HIV+ adults, with a mean age of 49.88 (SD = 12.03) diagnosed for an average of 9.39 (SD = 7.36) years. The psychometric properties of the short version of the Stigma Scale were analyzed through the one-factor structure and the original four-factor structure, showing good fit for this last model. Convergent validity was found to be close to the acceptable for the factors, “concerns about public attitudes” and “negative self-image”, and good for the factors, “disclosure concerns” and “personalized stigma”. The results showed adequate discriminant validity for all factors, coefficient Omega was above .70 for the four factors, showing adequate reliability. This Portuguese version of the Stigma Scale is a good measure to assess the stigma of people living with HIV.
Downloads
References
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238-46. https://doi.org/10.1037/0033-2909.107.2.238
Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588–606. https://doi.org/10.1037/0033-2909.88.3.588
Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Research in Nursing & Health, 24, 518-529. https://doi.org/10.1002/nur.10011
Brewer, M. B. (2007). The social psychology of intergroup relations: social categorization, ingroup bias, and outgroup prejudice. In A. W. Kruglanski & E. T. Higgins (Eds.), Social Psychology: Handbook of Basic Principles (pp. 695-715). The Guilford Press.
Bunn J. Y., Solomon S. E., Millar C., & Forehand R. (2007). Measurement of stigma in people with HIV: A re-examination of the HIV Stigma Scale. AIDS Education and Prevention, 19, 198–208. https://doi.org/10.1521/aeap.2007.19.3.198
Burnham, K. E., Cruess, D. G., Kalichman, M. O., Grebler, T., Cherry, C., & Kalichman, S. C. (2016). Trauma symptoms, internalized stigma, social support, and sexual risk behavior among HIV-positive gay and bisexual MSM who have sought sex partners online. AIDS Care, 28, 347-353. https://doi.org/10.1080/09540121.2015.1096894
Canavarro, M. (1995). Inventário de sintomas psicopatológicos - B.S.I. In M. R. Simões, M. Gonçalves, & L. S. Almeida (Eds), Testes e provas psicológicas em Portugal (vol. II, pp. 87-109). Braga: SHO/APPORT
Clark, L. A., & Watson, D. (1995). Constructing validity: Basic issues in objective scale development. Psychological Assessment, 7(3), 309–319. https://doi.org/10.1037/1040-3590.7.3.309
Comrey, A. L., & Lee, H. B. (1992). A first course in factor analysis (2nd ed.). Lawrence Erlbaum.
Deacon, H. (2006). Towards a sustainable theory of health‐related stigma: Lessons from the HIV/AIDS literature. Journal of Community & Applied Social Psychology, 16, 418-425. https://doi.org/10.1002/casp.900
Derlega, V. J., Winstead, B. A., Greene, K., Serovich, J., & Elwood, W. N. (2004). Reasons for HIV disclosure/nondisclosure in close relationships: Testing a model of HIV–disclosure decision making. Journal of Social and Clinical Psychology, 23, 747-767. https://doi.org/10.1521/jscp.23.6.747.54804
Dunn, T., Baguley, T., & Brunsden, V. (2014). From alpha to omega: A practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology, 105, 399–412. https://doi.org/10.1111/bjop.12046
Earnshaw, V. A., & Chaudoir, S. R. (2009). From conceptualizing to measuring HIV stigma: A review of HIV stigma mechanism measures. AIDS and Behavior, 13, 1160-1177. https://doi.org/10.1007/s10461-009-9593-3
Fachado, A., Martinez, M., Villalva, M., & Pereira, M. (2007). Adaptação cultural e validação da versão portuguesa questionário medical outcomes study social suporte survey (MOSSSS). Acta Médica Portuguesa, 20, 525-533.
Ferreira, J. A., & Castela, M. C. (1999). Questionário de ideação suicida. In M. R. Simões, M. M. Gonçalves, & L. S. Almeida (Ed), Testes e Provas Psicológicas em Portugal, (vol. II, pp. 123-130). APPORT/SHO.
Fife, B. L., & Wright, E. R. (2000). The dimensionality of stigma: A comparison of its impact on the self of persons with HIV/AIDS and cancer. Journal of Health and Social Behavior, 1, 50-67. https://doi.org/10.2307/2676360
Finch, W., Immekus, J., & French, B. (2016). Applied Psychometrics Using SPSS and AMOS. Information Age Publishing Inc.
Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.2307/3151312
Franke M. F., Muñoz M., Finnegan K., Zeladita J., Sebastian J. L., Bayona J. N., & Shin S. S. (2010). Validation and abbreviation of an HIV Stigma Scale in an adult Spanish-speaking population in urban Peru. AIDS and Behavior, 14, 189–199. https://doi.org/10.1007/s10461-008-9474-1
Fuster-Ruiz de Apodaca, M. J., Molero, F., Holgado, F. P., & Ubillos, S. (2015). Adaptation of the HIV Stigma Scale in Spaniards with HIV. The Spanish Journal of Psychology, 18, 1-15. https://doi.org/10.1017/S1138741615000694
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Simon & Schuster Inc.
Gonçalves, A. R. C. (2018). Fatores associados à adesão terapêutica em pessoas com VIH/SIDA [Factors associated with therapeutic adherence in people with HIV / AIDS] [Unpublished master thesis]. Universidade do Minho.
Heckman, T. G., Miller, J., Kochman, A., Kalichman, S. C., Carlson, B., & Silverthorn, M. (2002). Thoughts of suicide among HIV-infected rural persons enrolled in a telephone delivered mental health intervention. Annals of Behavioral Medicine, 24, 141-148. https://doi.org/10.1207/S15324796ABM2402_11
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1-55. https://doi.org/10.1080/10705519909540118
International Test Comission (2017). ITC Guidelines for Translating and Adapting Tests (Second Edition). International Journal of Testing, 18(2), 101-134. https://doi.org/10.1080/15305058.2017.1398166
Jeyaseelan, L., Kumar, S., Mohanraj, R., Rebekah, G., Rao, D., & Manhart, L. E. (2013). Assessing HIV/AIDS stigma in South India: Validation and abridgement of the Berger HIV stigma scale. AIDS and Behavior, 17, 434-443. https://doi.org/10.1007/s10461-011-0128-3
Jimenez J. C., Puig M., Ramos J. C., Morales M., Asencio G., Sala A. C., Castro, E., Velez Santori, C., Santiago, L., & Zorrilla C. (2010). Measuring HIV felt stigma: A culturally adapted scale targeting PLWHA in Puerto Rico. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV, 22(11), 1314–1322. https://doi.org/10.1080/09540121003758481
Kanahara, S. (2006). A Review of the definitions of stereotype and a proposal for a professional model. Individual Differences Research, 4, 306-321.
Kline, R. B. (2011). Principles and practice of structural equation modeling. Guilford Press.
Lindberg, M. H., Wettergren, L., Wiklander, M., Svedhem-Johansson, V., & Eriksson, L. E. (2014). Psychometric evaluation of the HIV stigma scale in a Swedish context. PLoS One, 9, 1-16. https://doi.org/10.1371/journal.pone.0114867
Logie, C., & Gadalla, T. M. (2009). Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS care, 21, 742-753. https://doi.org/10.1080/09540120802511877
Luz, P., Torres, T., Almeida-Brasil, C., Marins, L., Bezerra, D., Veloso, V. Grinsztejn, B., Harel, D., & Thombs, B. (2020). Translation and validation of the Short HIV Stigma scale in Brazilian Portuguese. Health Qual Life Outcomes, 18, 322 https://doi.org/10.1186/s12955-020-01571-1
Marôco, J. (2014). Análise de equações estruturais: Fundamentos teóricos, sostware & aplicações (2.ª Edição). ReportNumber.
Massicotte, A. C. R. (2010). A comparative analysis of quality of life and stigma experienced by people living with HIV receiving antiretroviral therapy in a home-based care project in Malema and Ribaue districts, Mozambique [Unpublished Doctoral dissertation]. University of South Africa, South Africa.
Matos, M. S. (2019). A vida continua: Vivência e adaptação de homens ao VIH/SIDA [Life goes on: Men's living and adapting to HIV / AIDS] [Unpublished master thesis]). Universidade do Minho.
Mo, P. K., & Ng, C. T. (2017). Stigmatization among people living with HIV in Hong Kong: A qualitative study. Health Expectations, 20, 943-951. https://doi.org/10.1111/hex.12535
NIH (2019). Relatório infeção VIH e SIDA em Portugal – 2019 [HIV infection and AIDS report in Portugal – 2019]. http://www.insa.min-saude.pt/relatorio-infecao-vih-e-sida-em-portugal-2019/
Orr, L., Shebl, F. M., Heimer, R., Khoshnood, K., Barbour, R., Khouri, D., Aaraj, E., Mokhbat, J. E., & Crawford, F. W. (2021). Violence and discrimination against men who have sex with men in Lebanon: The role of international displacement and migration. Journal of Interpersonal Violence, 36(21-22), 10267–10284. https://doi.org/10.1177/0886260519884684
Poon, C., Saewyc, E., & Chen, W. (2012). Enacted stigma, problem substance use, and protective factors among Asian sexual minority youth in British Columbia. Canadian Journal of Community Mental Health, 30, 47-64. https://doi.org/10.7870/cjcmh-2011-0016
Reinius, M., Wettergren, L., Wiklander, M., Svedhem, V., Ekström, A.M., & Eriksson, L. (2017). Development of a 12-item short version of the HIV stigma scale. Health Qual Life Outcomes, 15, 115. https://doi.org/10.1186/s12955-017-0691-z
Reisner, S. L., Pardo, S. T., Gamarel, K. E., Hughto, J. M. W., Pardee, D. J., & Keo-Meier, C. L. (2015). Substance use to cope with stigma in healthcare among US female-to-male trans masculine adults. LGBT Health, 2, 324-332. https://doi.org/10.1089/lgbt.2015.0001
Rueda, S., Mitra, S., Chen, S., Gogolishvili, D., Globerman, J., Chambers, L., Wilson, M., Logie, C. H., Shi, Q., Morassaei, S., & Rourke, S. B. (2016). Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: A series of meta-analyses. BMJ Open, 6(7), 1-15. https://doi.org/10.1136/bmjopen-2016-011453
Satorra, A., & Bentler, P.M. (1994). Corrections to test statistics and standard errors in covariance structure analysis. In A. von Eye & C.C. Clogg (Eds.) Latent variables analysis: applications for developmental research (pp. 399–419). Sage.
Satorra, A., & Bentler, P.M. (2001). A scaled difference chi-square test statistic for moment structure analysis. Psychometrika, 66, 507–514. https://doi.org/10.1007/BF02296192
Sayles, J. N., Hays, R. D., Sarkisian, C. A., Mahajan, A. P., Spritzer, K. L., & Cunningham, W. E. (2008). Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults. AIDS and Behavior, 12(5), 748-758. https://doi.org/10.1007/s10461-008-9375-3
Schmitt, T. A. (2011). Current methodological considerations in exploratory and confirmatory factor analysis. Journal of Psychoeducational Assessment, 29(4), 304-321. https://doi.org/10.1177/0734282911406653
Silva, C. F. L. (2016). Fatores preditores de psicopatologia em pessoas que vivem com VIH/SIDA [Predictors of psychopathology in people living with HIV/AIDS] [Unpublished master thesis]. Universidade do Minho.
Sousa, M. D. F. (2017). Variáveis associadas à ideação suicida em pessoas com VIH – Sida [Variables associated with suicidal ideation in people with HIV – AIDS] [Unpublished master thesis]. Universidade do Minho.
Steiger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioral Research, 25, 173−180. https://doi.org/10.1207/s15327906mbr2502_4
Steiger, J. H., Shapiro, A., & Browne, M. W. (1985). On the multivariate asymptotic distribution of sequential chi-square statistics. Psychometrika, 50, 253−263. https://doi.org/10.1007/BF02294104
Steward, W. T., Herek, G. M., Ramakrishna, J., Bharat, S., Chandy, S., Wrubel, J., & Ekstrand, M. L. (2008). HIV-related stigma: Adapting a theoretical framework for use in India. Social Science & Medicine, 67, 1225-1235. https://doi.org/10.1016/j.socscimed.2008.05.032
Tanaka, J. S., & Huba, G. J. (1985). A fit index for covariance structure models under arbitrary GLS estimation. British Journal of Mathematical and Statistical Psychology, 38(2), 197–201. https://doi.org/10.1111/j.2044-8317.1985.tb00834.x
Wagner, G. J., Bogart, L. M., Klein, D. J., Green, H. D., Mutchler, M. G., McDavitt, B., & Hilliard, C. (2016). Association of internalized and social network level HIV stigma with high-risk condomless sex among HIV-positive African American men. Archives of Sexual Behavior, 45, 1347-1355. https://doi.org/10.1007/s10508-015-0641-y
World Health Organization (2018). Global Health Observatory Data. https://www.who.int/gho/hiv/en/
