Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
AIDS Behav. 2020 Sep;24(9):2637-2649. doi: 10.1007/s10461-020-02820-6.
Stigma regarding HIV pre-exposure prophylaxis (PrEP) is commonly implicated as a factor limiting the scale-up of this highly effective HIV prevention modality. To quantify and characterize PrEP stigma, we developed and validated a brief HIV PrEP Stigma Scale (HPSS) among a group of 279 men who have sex with men (MSM). Scale development was informed by a theoretical model to enhance content validity. We assessed two scale versions, Semantic Differential and Likert, randomizing the order in which scales were presented to participants. Both scales demonstrated high internal consistency. The Likert scale had substantially better construct validity and was selected as the preferred option. Scale scores demonstrated construct validity through association with constructs of interest: healthcare distrust, HIV knowledge, perceived proportion of friends/partners on PrEP, perceived community evaluation of PrEP, and perceived effectiveness of PrEP. The scale accounted for 25% of the total variance in reported willingness to be on PrEP, indicating the substantial role PrEP stigma may have on decisions to initiate PrEP. Given increased efforts to roll-out PrEP, having a valid tool to determine the level and types of PrEP stigma in individuals, groups, and communities can help direct implementation plans, identify goals for stigma reduction, and monitor progress over time.
艾滋病毒暴露前预防（PrEP）的污名通常被认为是限制这种高效艾滋病毒预防方式扩大规模的一个因素。为了量化和描述 PrEP 污名，我们在一组 279 名男男性行为者（MSM）中开发并验证了一种简短的艾滋病毒 PrEP 污名量表（HPSS）。量表的开发得到了一个理论模型的指导，以增强内容的有效性。我们评估了两种量表版本，语义差异和李克特，随机呈现量表给参与者的顺序。两种量表都显示出了很高的内部一致性。李克特量表具有更好的结构有效性，因此被选为首选。通过与感兴趣的结构的关联，量表得分表现出了结构有效性：对医疗保健的不信任、艾滋病毒知识、对朋友/伴侣中使用 PrEP 的比例的感知、对社区对 PrEP 的评价的感知以及对 PrEP 有效性的感知。该量表解释了报告愿意接受 PrEP 的意愿的 25%的总方差，表明 PrEP 污名可能对启动 PrEP 的决定有很大影响。鉴于扩大 PrEP 的推出，拥有一个有效的工具来确定个人、群体和社区中 PrEP 污名的程度和类型，可以帮助指导实施计划，确定减少污名的目标，并随着时间的推移监测进展。
