Population Council, Washington, District of Columbia.
Population Council, New York, New York, USA.
AIDS. 2020 Sep 1;34 Suppl 1:S33-S41. doi: 10.1097/QAD.0000000000002649.
Measuring internalized stigma is critical to understanding its impact on the health and quality of life of people living with HIV (PLHIV). The aim of this study was to assess the performance of the Internalized AIDS-Related Stigma Scale (IA-RSS).
Secondary analysis of the six-item IA-RSS was conducted using data from four cross-sectional surveys implemented in Cambodia (n = 1207), the Dominican Republic (n = 891), Uganda (n = 391) and Tanzania (n = 529) between 2018 and 2019.
IA-RSS scale item distribution was described. Multivariate regression models measured correlations between the IA-RSS and depression, antiretroviral therapy (ART) use and viral suppression. Confirmatory factor analysis assessed IA-RSS reliability and performance through analysis of standardized factor loadings and conditional probabilities of scale items. Analysis of qualitative interviews with PLHIV explored acceptability of IA-RSS item content.
Mean IA-RSS scores (possible 0-6) ranged from 2.06 (Uganda) to 3.84 (Cambodia), and internal consistency was more than 0.70 in each country (Kuder-Richardson 20), ranging from 0.71 to 0.83. Higher IA-RSS scores were strongly correlated with depression in (P < 0.001 in all countries), and inversely associated with current ART use (Dominican Republic and Tanzania) and self-reported viral suppression (Uganda and Tanzania). Confirmatory factor analysis showed good model fit (all CFI ≥ 0.950), but also that the IA-RSS may summarize two domains related to HIV status disclosure (two items) and PLHIV feelings about themselves (four items).
Strong performance across countries supports continued use of the IA-RSS. Further study is needed to explore potential item refinements and to better understand the relationship between internalized stigma and HIV treatment outcomes.
衡量内化污名对于了解其对艾滋病毒感染者（PLHIV）的健康和生活质量的影响至关重要。本研究的目的是评估艾滋病相关内化污名量表（IA-RSS）的性能。
使用 2018 年至 2019 年期间在柬埔寨（n=1207）、多米尼加共和国（n=891）、乌干达（n=391）和坦桑尼亚（n=529）进行的四项横断面调查的数据，对六分量表的 IA-RSS 进行了二次分析。
描述了 IA-RSS 量表项目的分布。多元回归模型衡量了 IA-RSS 与抑郁、抗逆转录病毒治疗（ART）使用和病毒抑制之间的相关性。通过对量表项目的标准化因子负荷和条件概率进行分析，对 IA-RSS 的可靠性和性能进行了验证性因子分析。对 PLHIV 的定性访谈分析探讨了 IA-RSS 项目内容的可接受性。
IA-RSS 平均得分（可能为 0-6）范围为 2.06（乌干达）至 3.84（柬埔寨），每个国家的内部一致性均大于 0.70（Kuder-Richardson 20），范围为 0.71 至 0.83。IA-RSS 得分越高，与抑郁的相关性越强（所有国家均为 P<0.001），与当前 ART 使用（多米尼加共和国和坦桑尼亚）和自我报告的病毒抑制（乌干达和坦桑尼亚）呈负相关。验证性因子分析表明模型拟合良好（所有 CFI≥0.950），但也表明 IA-RSS 可能总结了与 HIV 状态披露（两个项目）和 PLHIV 对自己的感觉（四个项目）相关的两个领域。
在多个国家的良好表现支持继续使用 IA-RSS。需要进一步研究来探索潜在的项目改进，并更好地理解内化污名与 HIV 治疗结果之间的关系。
