Substance use stigma mechanisms scale: Factor structure, reliability, and validity in Mexican adults that use drugs

Abstract

BackgroundStudies among the Mexican population have suggested that stigma towards persons who use drugs (PWUD) may act as a barrier to treatment seeking and contribute to negative health consequences. However, there has not been a validated scale to measure this construct. This paper aims to validate the Substance Use Stigma Mechanisms Scale (SU-SMS) in a sample of Mexican adults who use drugs. This 18-item scale was developed to differentiate substance use stigma mechanisms and learn their impact on the health and wellbeing of persons who use drugs (PWUD) in the United States. MethodsA sample of 407 adults with a median age of 27 years old completed a web-based version in Spanish of the SU-SMS, the WHO-ASSIST screening instrument, as well as sociodemographic and substance-use-related characteristics. We performed exploratory factor analysis with weighted least squares and oblique rotation, and correlations within and between mechanisms of stigma, and substance use. ResultsThe Spanish translation of the SU-SMS has adequate internal consistency (Ω=0.92) and the same factor structure as the original scale. A five-factor solution with internalized, enacted, and anticipated stigma from family and healthcare workers showed adequate concurrent validity. Mechanisms of stigma were correlated between them, within sources, and negatively correlated with current substance use treatment. ConclusionsThe Spanish translation of the scale seems to be a valid and sensitive scale that can be used among Mexican PWUD.