Beaulieu Marianne, Adrien Alix, Potvin Louise, Dassa Clément
Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada.
BMC Public Health. 2014 Dec 4;14:1246. doi: 10.1186/1471-2458-14-1246.
Although stigmatization has long been recognized as a major obstacle to HIV prevention. The lack of a valid and reliable measurement tool for stigmatization is a major gap in the research. This study aimed to: 1) develop a scale of stigmatizing attitudes towards people living with HIV (SAT-PLWHA-S) and 2) demonstrate its reliability and validity.
French and English-speaking experts (n = 21) from different professional communities (academics, practitioners) assessed the clarity and relevance of the proposed items. The psychometric properties of the SAT-PLWHA-S were assessed with a random digit dial population based telephone survey (n = 1,500) of respondents in Quebec, Canada. Analyses included exploratory and confirmatory factor analyses, correlations, multiple linear regressions, t-tests, hypothesis testing of factorial structure invariance, and Cronbach's alpha.
Confirmatory factor analysis (CFA) supported a 27-item structure with seven factors: 1) concerns about occasional encounters; 2) avoidance of personal contact; 3) responsibility and blame, 4) liberalism, 5) non-discrimination, 6) confidentiality of seropositive status, and 7) criminalization of HIV transmission. Cronbach's alphas indicate satisfactory internal consistency. An assessment of concurrent validity using Pearson's correlation and multiple linear regression shows that homophobia and HIV transmission knowledge are significant determinants of stigmatizing attitudes toward PLHIV. Discriminant validity (t-test) results suggest that the SAT-PLWHA-S can differentiate attitudes between different groups and indicates invariant factor structure across language.
The results of this study suggest that the SAT-PLWHA-S is a reliable and valid tool for measuring stigmatizing attitudes toward PLHIV and that it can contribute to a deeper understanding of HIV stigma.
尽管污名化长期以来一直被认为是艾滋病毒预防的主要障碍。但缺乏一种有效且可靠的污名化测量工具是该研究领域的一个重大空白。本研究旨在：1）开发一种针对艾滋病毒感染者的污名化态度量表（SAT - PLWHA - S）；2）证明其可靠性和有效性。
来自不同专业群体（学者、从业者）的法语和英语专家（n = 21）评估了所提议项目的清晰度和相关性。通过对加拿大魁北克省基于随机数字拨号抽样的电话调查（n = 1500）受访者进行SAT - PLWHA - S的心理测量特性评估。分析包括探索性和验证性因素分析、相关性分析、多元线性回归、t检验、因子结构不变性的假设检验以及克朗巴哈系数。
验证性因素分析（CFA）支持一个包含27个项目、七个因子的结构：1）对偶然接触的担忧；2）避免个人接触；3）责任与责备；4）自由主义；5）非歧视；6）血清阳性状态的保密性；7）将艾滋病毒传播定罪。克朗巴哈系数表明内部一致性令人满意。使用皮尔逊相关性和多元线性回归进行的同时效度评估表明，恐同症和艾滋病毒传播知识是对艾滋病毒感染者污名化态度的重要决定因素。判别效度（t检验）结果表明，SAT - PLWHA - S能够区分不同群体之间的态度，并表明跨语言的因子结构不变。
本研究结果表明，SAT - PLWHA - S是一种可靠且有效的工具，用于测量对艾滋病毒感染者的污名化态度，并且有助于更深入地理解艾滋病毒污名化问题。
