Top

Published in:

01-01-2013 | Original Paper

Assessing HIV/AIDS Stigma in South India: Validation and Abridgement of the Berger HIV Stigma Scale

Published in: AIDS and Behavior | Issue 1/2013

Abstract

HIV-related stigma has been associated with depression, poor adherence, and nondisclosure of HIV-positive status, all of which can lead to increased transmission of HIV and poorer health outcomes for HIV-infected individuals. The Berger HIV Stigma scale has been used in multiple settings but never adapted and validated in India, home to the world’s second largest HIV-infected population. We assessed the reliability and validity of a Tamil translation of the original 40-item scale, and conducted confirmatory and exploratory factor analyses to assess cultural appropriateness and abbreviate the scale. Reliability and validity were high (alpha = 0.91; test–retest reliability ICC = 0.89). Exploratory and confirmatory factor analysis resulted in an abridged 25-item version of the scale that possessed better psychometric properties than the 40-item version. This culturally validated, abridged HIV-Stigma scale can be used in busy clinical settings to identify individuals in need of psychosocial support and assess post-intervention changes in stigma in Southern India.

Simoes EA, Babu PG, John TJ, Nirmala S, Solomon S, Lakshminarayana CS, et al. Evidence for HTLV-III infection in prostitutes in Tamil Nadu (India). Indian J Med. 1987;85:335–8.

National AIDS Control Organization: Facts and figures. http://www.nacoonline.org/facts.htm (2007). Accessed 28 Mar 2007.

Kumar R, Jha P, Arora P, Mony P, Bhatia P, Millson P, et al. Trends in HIV-1 in young adults in south India from 2000 to 2004: a prevalence study. Lancet. 2006;367(9517):1164–72.PubMedCrossRef

UNAIDS: Stigma and discrimination. http://www.unaids.org/en/Issues/Prevention_treatment/stigma.asp (2007). Accessed 9 Apr 2007.

Simbayi LC, Kalichman S, Strebel A, Cloete A, Henda N, Mqeketo A. Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Soc Sci Med. 2007;64(9):1823–31.PubMedCrossRef

Leonard AD, Markham CM, Bui T, Shegog R, Paul ME. Lowering the risk of secondary HIV transmission: insights from HIV-positive youth and health care providers. Perspect Sex Reprod Health. 2010;42(2):110–6.PubMedCrossRef

Curioso WH, Kepka D, Cabello R, Segura P, Kurth AE. Understanding the facilitators and barriers of antiretroviral adherence in Peru: a qualitative study. BMC Public Health. 2010;10:13.PubMedCrossRef

Chandra PS, Deepthivarma S, Manjula V. Disclosure of HIV infection in south India: patterns, reasons and reactions. AIDS Care. 2003;15(2):207–15.PubMedCrossRef

Subramanian T, Gupte MD, Dorairaj VS, Periannan V, Mathai AK. Psycho-social impact and quality of life of people living with HIV/AIDS in South India. AIDS Care. 2009;21(4):473–81.PubMedCrossRef

10.

Thomas BE, Rehman F, Suryanarayanan D, Josephine K, Dilip M, Dorairaj VS, et al. How stigmatizing is stigma in the life of people living with HIV: a study on HIV positive individuals from Chennai, South India. AIDS Care. 2005;17(7):795–801.PubMedCrossRef

11.

Kumarasamy N, Safren SA, Raminani SR, Pickard R, James R, Krishnan AK, et al. Barriers and facilitators to antiretroviral medication adherence among patients with HIV in Chennai, India: a qualitative study. AIDS Patient Care STDS. 2005;19(8):526–37.PubMedCrossRef

12.

Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.PubMedCrossRef

13.

Franke MF, Munoz M, Finnegan K, Zeladita J, Sebastian JL, Bayona JN, et al. Validation and abbreviation of an HIV stigma scale in an adult spanish-speaking population in urban Peru. AIDS Behav. 2010;14(1):189–99.PubMedCrossRef

14.

Wright K, Naar-King S, Lam P, Templin T, Frey M. Stigma scale revised: reliability and validity of a brief measure of stigma for HIV+ youth. J Adolesc Health. 2007;40(1):96–8.PubMedCrossRef

15.

Bunn JY, Solomon SE, Miller C, Forehand R. Measurement of stigma in people with HIV: a reexamination of the HIV stigma scale. AIDS Educ Prev. 2007;19(3):198–208.PubMedCrossRef

16.

Steward WT, Herek GM, Ramakrishna J, Bharat S, Chandy S, Wrubel J, et al. HIV-related stigma: adapting a theoretical framework for use in India. Soc Sci Med. 2008;67(8):1225–35.PubMedCrossRef

17.

Zelaya CE, Sivaram S, Johnson SC, Srikrishnan AK, Solomon S, Celentano DD. HIV/AIDS stigma: reliability and validity of a new measurement instrument in Chennai, India. AIDS Behav. 2008;12(5):781–8.PubMedCrossRef

18.

Van Brakel WH. Measuring health-related stigma—a literature review. Psychol Health Med. 2006;11(3):307–34.PubMedCrossRef

19.

Rao D, Choi SW, Victorson D, Bode R, Peterman A, Heinemann A, et al. Measuring stigma across neurological conditions: the development of the stigma scale for chronic illness (SSCI). Qual Life Res. 2009;18(5):585–95.PubMedCrossRef

20.

Holzemer WL, Makoae LN, Greeff M, Dlamini PS, Kohi TW, Chirwa ML, et al. Measuring HIV stigma for PLHAs and nurses over time in five African countries. Sahara J. 2009;6(2):76–82.PubMedCrossRef

21.

Nyblade LC. Measuring HIV stigma: existing knowledge and gaps. Psychol Health Med. 2006;11(3):335–45.PubMedCrossRef

22.

Streiner D, Norman G. Health measurement scales: a practical guide to their development and use. New York: Oxford University Press; 1989.

23.

Rao D, Choi S, Victorson D, Bode R, Heinemann A, Peterman A, et al. Measuring stigma across neurological conditions: the development of the stigma scale for chronic illness (SSCI). Qual Life Res. 2009;18:585–95.PubMedCrossRef

24.

Lai J, Crane P, Cella D. Factor analysis techniques for assessing sufficient unidimensionality of cancer related fatigue. Qual Life Res. 2006;15(7):1179–90.PubMedCrossRef

25.

Bech, P.: The major (ICD-10) depression inventory (MDI). http://www.gp-training.net/protocol/psych/who/mdi.doc (2007). Accessed 11 Apr 2007.

26.

Olsen LR, Jensen DV, Noerholm V, Martiny K, Bech P. The internal and external validity of the major depression inventory in measuring severity of depressive states. Psychol Med. 2003;33(2):351–6.PubMedCrossRef

27.

Cella D, Hernandez L, Bonomi A, Corona M, Vaquero M, Shiomoto G, et al. Spanish language translation and initial validation of the functional assessment of cancer therapy quality-of-life instrument. Med Care. 1998;36(9):1407–18.PubMedCrossRef

28.

Bonomi A, Cella D, Hahn E, Bjordal K, Sperner-Unterweger B, Gangeri L, et al. Multilingual translation of the functional assessment of cancer therapy (FACT) quality of life measurement system. Qual Life Res. 1996;5(3):309–20.PubMedCrossRef

29.

Streiner DL. A checklist for evaluating the usefulness of rating scales. Can J Psychiatry. 1993;38(2):140–8.PubMed

30.

Alonzo AA, Reynolds NR. Stigma, HIV and AIDS: an exploration and elaboration of a stigma trajectory. Soc Sci Med. 1995;41:303–15.PubMedCrossRef

31.

Barua A, Kar N. Screening for depression in elderly Indian population. Indian J Psychiatry. 2010;52(2):150–3.PubMedCrossRef

32.

McDonald RP, Ho MH. Principles and practice in reporting structural equation analyses. Psychol Methods. 2002;7(1):64–82.PubMedCrossRef

33.

Crowley SL, Fan X. Structural equation modeling: basic concepts and applications in personality assessment research. J Pers Assess. 1997;68(3):508–31.PubMedCrossRef

34.

Musil CM, Jones SL, Warner CD. Structural equation modeling and its relationship to multiple regression and factor analysis. Res Nurs Health. 1998;21(3):271–81.PubMedCrossRef

35.

Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon and Schuster, Inc.; 1963.

36.

Laryea M, Gien L. The impact of HIV-positive diagnosis on the individual, Part 1: stigma, rejection, and loneliness. Clin Nurs Res. 1993;2(3):245–63. discussion 63–66.PubMedCrossRef

37.

Hattie J. Methodology review: assessing unidimensionality of tests and items. Appl Psychol Meas. 1985;9:139–64.CrossRef

Title: Assessing HIV/AIDS Stigma in South India: Validation and Abridgement of the Berger HIV Stigma Scale
Publication date: 01-01-2013
Published in: AIDS and Behavior / Issue 1/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-011-0128-3

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Assessing HIV/AIDS Stigma in South India: Validation and Abridgement of the Berger HIV Stigma Scale

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2013

MACH14: A Multi-Site Collaboration on ART Adherence Among 14 Institutions

The Relationship Between Perceived Discrimination and High-Risk Social Ties Among Illicit Drug Users in New York City, 2006–2009

Association Between Use of Specific Drugs and Antiretroviral Adherence: Findings from MACH 14

A Proposal for Quality Standards for Measuring Medication Adherence in Research

Effect of a Clinic-Wide Social Marketing Campaign to Improve Adherence to Antiretroviral Therapy for HIV Infection

Injection Drug Use and HIV Antiretroviral Therapy Discontinuation in A Canadian Setting

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page