Abstract
Courtesy stigma is the stigmatization a person perceives or experiences due to their association with a stigmatized individual or group. Most HIV-related stigma scales have been developed for people living with HIV/AIDS (PLWHAs), but not for their HIV-uninfected family members. To date, few measurement scales have been designed to measure the degree of stigma among both PLWHAs and their HIV-uninfected family members at the family level. We developed a set of courtesy stigma scales and estimated their reliability and validity from 256 PLWHAs and 256 of their HIV-uninfected family members. Exploratory and confirmatory factor analyses were performed in two independent samples: a development sample (N = 216) and a validation sample (N = 296), respectively. Two factors (“public stigma” and “self-perceived stigma”) had high internal consistency reliability (Cronbach's alpha coefficient between 0.83–0.90) and good construct validity (standardized factor loading range: 0.37–0.95) in both samples. These findings document that the newly developed brief instrument is a psychometrically sound measure of HIV-related stigma among both PLWHAs and their HIV-uninfected family members.
Highlights
Stigma continues to be a major barrier to the treatment-asprevention strategy for HIV interventions [1,2]
people living with HIV/AIDS (PLWHAs) and 108 HIV-uninfected family members) who participated in the interview
The findings of this study demonstrate that the Chinese Courtesy Stigma Scales (CCSSs) can reliably capture courtesy stigma among HIV-uninfected family members of PLWHAs
Summary
Stigma continues to be a major barrier to the treatment-asprevention strategy for HIV interventions [1,2]. Despite ongoing efforts to reduce stigma among people affected by HIV/AIDS, its deleterious effects persist. Stigma does exist in people living with HIV/AIDS (PLWHAs), but their family members, relatives, neighbors, and communities with which they are affiliated [3]. With regard to the HIV/AIDS epidemic, HIV-related stigma refers to prejudice, discounting, discrediting, and discrimination directed at people who are infected or affected by HIV/AIDS [5,6]. Previous studies have documented that a higher level of HIV-stigma was strongly associated with a higher level of depression and a low level of selfefficacy [7,8,9,10]. As reported in a longitudinal study conducted in South Africa, HIV-related stigma persists across time and mediates the relationship between HIV/AIDS orphanhood and psychological distress (anxiety and depression) [11]
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