Abstract
BackgroundStigma related to abortion and contraceptive use is a serious public health threat for young people, and validated scales to measure this stigma are scarce. The purposes of the study were to validate a newly constructed scale to measure the stigma of contraceptive use and to adapt a scale to measure the stigma of abortion.MethodsA study nested in a cluster-randomised trial. In 2017, data was collected from 633 secondary school youths, in a semi-urban setting in western Kenya. A qualitative pre-phase (face-validity) were initially utilised to draft and validate a seven-item scale to capture contraceptive use stigma (CUS) and to adapt the Stigmatizing Attitudes, Beliefs and Actions (SABA) scale (18 items), which captures aspects of abortion stigma. Statistical tests used included test-retest reliability analysis, Pearson’s correlation coefficients, Wilcoxon signed-rank test, Factor Analysis, Principal Component Analysis, interclass correlation and Cronbach’s alpha.ResultsFor the CUS scale, paired t-test and Wilcoxon signed-rank test showed no significant score changed between time points (p = 0.64; 0.67). CUS had similar patterns between time points, with two relevant components: promiscuity and lack of autonomy. Cronbach’s alpha indicated acceptable internal consistency between time points (0.71;0.7). The confirmatory factor loadings for each item in the modified three subscales of SABA had a similar pattern to the original SABA scale, in particularly regarding negative stereotyping and, excluding and discriminating factors. The Cronbach’s alpha was adequate, although lower for the modified SABA (0.74) as compared to the original SABA (0.9). The SABA scale was renamed into Adolescents Stigmatizing Attitudes, Beliefs and Action (ASABA) scale.ConclusionsThe CUS scale is considered valid and reliable for measuring contraceptive use stigma, and the ASABA scale was rated as reliable for capturing abortion stigma based on negative stereotyping and excluding and discriminating factors. The CUS, up to date the first ever proposed CUS scale, and the ASABA scale can be used to measure effects of stigma reduction interventions with the aim of preventing unintended pregnancies, motherhood and unsafe abortion among adolescents in Kenya and similar low-resource settings.
Highlights
Stigma related to abortion and contraceptive use is a serious public health threat for young people, and validated scales to measure this stigma are scarce
Contraceptive use stigma and abortion stigma largely nourishes from gender stereotypes, which are used to deny girls and women access to abortion and contraceptive services
Adolescents are the far most affected population suffering from contraceptive use stigma and abortion stigma
Summary
Stigma related to abortion and contraceptive use is a serious public health threat for young people, and validated scales to measure this stigma are scarce. Surveys that ask about sexual activity do not always include unmarried women, and even when they do, these women may underreport their sexual activity and contraceptive use due to an unwillingness to risk social disapproval and stigmatising attitudes associated with nonmarital sexual activities [17,18,19] Both women and men have concerns about the effects of contraceptive methods on women’s bodies, including their weight, menstrual cycles, libido, sexual desirability and pleasure [20,21,22,23]. Such studies reveal that both men’s and women’s resistance to contraception could be related to traditional gender norms and power, or to a suspicion that outsiders (Westerners) aim to control women’s fertility [19]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
