Measurement characteristics and correlates of HIV-related stigma among adults living with HIV: a cross-sectional study from coastal Kenya

ObjectiveWe studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.DesignCross-sectional study.SettingComprehensive Care and Research Centre in the Kilifi Count...

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Published in:BMJ open 2022-02, Vol.12 (2), p.e050709-e050709
Main Authors: Wanjala, Stanley W, Nyongesa, Moses K, Mwangi, Paul, Mutua, Agnes M, Luchters, Stanley, Newton, Charles R J C, Abubakar, Amina
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adults
AIDS
Antiretroviral drugs
Anxiety disorders
Cross-sectional studies
Data collection
Disclosure
epidemiology
HIV
HIV & AIDS
Human immunodeficiency virus
Infections
Medical screening
Patients
Public health
Quantitative psychology
Questionnaires
Self image
Stigma
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creator Wanjala, Stanley W
Nyongesa, Moses K
Mwangi, Paul
Mutua, Agnes M
Luchters, Stanley
Newton, Charles R J C
Abubakar, Amina
description ObjectiveWe studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.DesignCross-sectional study.SettingComprehensive Care and Research Centre in the Kilifi County Hospital.ParticipantsAdults living with HIV on combination antiretroviral therapy were recruited and interviewed between February and April 2018 (n=450).Main outcome measuresHIV-related stigma.Results450 participants with a median age of 43 years (IQR=36–50) took part in the study. Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, test–retest reliability intraclass correlation coefficient=0.92). Using confirmatory factor analysis, we observed that the 12-item short version of the HIV stigma scale had a good fit for its hypothesised model (Comparative Fit Index=0.966, Tucker Lewis Index=0.955, root mean square error of approximation=0.044). Multigroup confirmatory factor analysis indicated measurement invariance across gender and age groups as ΔCFI was ≤0.01. Multivariate linear regression established that being female (β=2.001, 95% CI: 0.21 to 3.80, p=0.029), HIV status non-disclosure (β=4.237, 95% CI: 1.27 to 7.20, p=0.005) and co-occurrence of depressive and anxiety symptoms (β=6.670, 95% CI: 3.40 to 9.94, p
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Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, test–retest reliability intraclass correlation coefficient=0.92). Using confirmatory factor analysis, we observed that the 12-item short version of the HIV stigma scale had a good fit for its hypothesised model (Comparative Fit Index=0.966, Tucker Lewis Index=0.955, root mean square error of approximation=0.044). Multigroup confirmatory factor analysis indicated measurement invariance across gender and age groups as ΔCFI was ≤0.01. Multivariate linear regression established that being female (β=2.001, 95% CI: 0.21 to 3.80, p=0.029), HIV status non-disclosure (β=4.237, 95% CI: 1.27 to 7.20, p=0.005) and co-occurrence of depressive and anxiety symptoms (β=6.670, 95% CI: 3.40 to 9.94, p&lt;0.001) were significant predictors of perceived HIV-related stigma and that these variables accounted for 10.2% of the explained variability in HIV-related stigma among adults living with HIV from Kilifi.ConclusionsOur results indicate that the 12-item short version of the HIV stigma scale is a valid and reliable measure of HIV stigma in Kenya. Furthermore, our study indicates that interventions aimed at reducing stigma need to take into account gender to address the specific needs of women, people who have not disclosed their HIV status, and those exhibiting symptoms of depression and anxiety, thereby improving their quality of life.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2021-050709</identifier><identifier>PMID: 35193904</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Acquired immune deficiency syndrome ; Adults ; AIDS ; Antiretroviral drugs ; Anxiety disorders ; Cross-sectional studies ; Data collection ; Disclosure ; epidemiology ; HIV ; HIV &amp; AIDS ; Human immunodeficiency virus ; Infections ; Medical screening ; Patients ; Public health ; Quantitative psychology ; Questionnaires ; Self image ; Stigma</subject><ispartof>BMJ open, 2022-02, Vol.12 (2), p.e050709-e050709</ispartof><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b539t-8b29ee42f92c8095a16ff16fa9088fa65cbefe9ddda90900e86592beb06ecfb83</citedby><cites>FETCH-LOGICAL-b539t-8b29ee42f92c8095a16ff16fa9088fa65cbefe9ddda90900e86592beb06ecfb83</cites><orcidid>0000-0003-1422-0162 ; 0000-0002-7761-0718</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2632248212/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2632248212?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3194,25753,27924,27925,37012,37013,44590,53791,53793,55341,55350,75126,77596,77597,77660,77686</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35193904$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wanjala, Stanley W</creatorcontrib><creatorcontrib>Nyongesa, Moses K</creatorcontrib><creatorcontrib>Mwangi, Paul</creatorcontrib><creatorcontrib>Mutua, Agnes M</creatorcontrib><creatorcontrib>Luchters, Stanley</creatorcontrib><creatorcontrib>Newton, Charles R J C</creatorcontrib><creatorcontrib>Abubakar, Amina</creatorcontrib><title>Measurement characteristics and correlates of HIV-related stigma among adults living with HIV: a cross-sectional study from coastal Kenya</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><addtitle>BMJ Open</addtitle><description>ObjectiveWe studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.DesignCross-sectional study.SettingComprehensive Care and Research Centre in the Kilifi County Hospital.ParticipantsAdults living with HIV on combination antiretroviral therapy were recruited and interviewed between February and April 2018 (n=450).Main outcome measuresHIV-related stigma.Results450 participants with a median age of 43 years (IQR=36–50) took part in the study. Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, test–retest reliability intraclass correlation coefficient=0.92). Using confirmatory factor analysis, we observed that the 12-item short version of the HIV stigma scale had a good fit for its hypothesised model (Comparative Fit Index=0.966, Tucker Lewis Index=0.955, root mean square error of approximation=0.044). Multigroup confirmatory factor analysis indicated measurement invariance across gender and age groups as ΔCFI was ≤0.01. Multivariate linear regression established that being female (β=2.001, 95% CI: 0.21 to 3.80, p=0.029), HIV status non-disclosure (β=4.237, 95% CI: 1.27 to 7.20, p=0.005) and co-occurrence of depressive and anxiety symptoms (β=6.670, 95% CI: 3.40 to 9.94, p&lt;0.001) were significant predictors of perceived HIV-related stigma and that these variables accounted for 10.2% of the explained variability in HIV-related stigma among adults living with HIV from Kilifi.ConclusionsOur results indicate that the 12-item short version of the HIV stigma scale is a valid and reliable measure of HIV stigma in Kenya. 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Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, test–retest reliability intraclass correlation coefficient=0.92). Using confirmatory factor analysis, we observed that the 12-item short version of the HIV stigma scale had a good fit for its hypothesised model (Comparative Fit Index=0.966, Tucker Lewis Index=0.955, root mean square error of approximation=0.044). Multigroup confirmatory factor analysis indicated measurement invariance across gender and age groups as ΔCFI was ≤0.01. Multivariate linear regression established that being female (β=2.001, 95% CI: 0.21 to 3.80, p=0.029), HIV status non-disclosure (β=4.237, 95% CI: 1.27 to 7.20, p=0.005) and co-occurrence of depressive and anxiety symptoms (β=6.670, 95% CI: 3.40 to 9.94, p&lt;0.001) were significant predictors of perceived HIV-related stigma and that these variables accounted for 10.2% of the explained variability in HIV-related stigma among adults living with HIV from Kilifi.ConclusionsOur results indicate that the 12-item short version of the HIV stigma scale is a valid and reliable measure of HIV stigma in Kenya. Furthermore, our study indicates that interventions aimed at reducing stigma need to take into account gender to address the specific needs of women, people who have not disclosed their HIV status, and those exhibiting symptoms of depression and anxiety, thereby improving their quality of life.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>35193904</pmid><doi>10.1136/bmjopen-2021-050709</doi><orcidid>https://orcid.org/0000-0003-1422-0162</orcidid><orcidid>https://orcid.org/0000-0002-7761-0718</orcidid><oa>free_for_read</oa></addata></record>
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subjects Acquired immune deficiency syndrome
Adults
AIDS
Antiretroviral drugs
Anxiety disorders
Cross-sectional studies
Data collection
Disclosure
epidemiology
HIV
HIV & AIDS
Human immunodeficiency virus
Infections
Medical screening
Patients
Public health
Quantitative psychology
Questionnaires
Self image
Stigma
title Measurement characteristics and correlates of HIV-related stigma among adults living with HIV: a cross-sectional study from coastal Kenya
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