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在缅甸进行文化适应的 HIV 污名量表的适应和验证。

Adaptation and validation of a culturally adapted HIV stigma scale in Myanmar.

机构信息

School of Nursing, Fujian Medical University, Fuzhou, China.

School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.

出版信息

BMC Public Health. 2021 Sep 13;21(1):1663. doi: 10.1186/s12889-021-11685-w.


DOI:10.1186/s12889-021-11685-w
PMID:34517850
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8439000/
Abstract

BACKGROUND: HIV stigma is a common barrier to HIV prevention, testing, and treatment adherence, especially for low- and middle-income countries such as Myanmar. However, there was no validated Myanmar version of a stigma scale. Therefore, we adapted the English version of the 40-item Berger's HIV stigma scale and the 7-item Indian HIV stigma scale into a 47-item Myanmar HIV stigma scale and then evaluated the scale's psychometric properties. METHOD: From January 2020 to May 2020, using random sampling methods, 216 eligible Myanmar people living with HIV/AIDS (PLWHA) were contacted from a closed Facebook group that included more than 10,000 PLWHA. A sample of 156 Myanmar PLWHA completed the online self-reported survey. RESULTS: A six-factor structure for the scale was determined through exploratory factor analysis, explaining 68.23% of the total variance. After deleting 12 items, the 35-item HIV stigma scale achieved Cronbach 's α of 0.72 to 0.95. Construct validity of the scale was demonstrated by significant association with self-reported depression and social support levels (r = 0.60, and - 0.77, p < 0.01). In Rasch analysis, the scale achieved person reliability of 3.40 and 1.53 and a separation index of 0.92 and 0.70. The infit and outfit mean squares for each item ranged from 0.68 to 1.40. No differential item functioning across gender or educational level was found. CONCLUSIONS: The psychometric properties of the 35-item Myanmar version of the HIV stigma scale support it as a measure of stigma among PLWHA in Myanmar. This instrument could help healthcare providers to better understand how stigma operates in PLWHA and to develop tailored stigma-reduction interventions in Myanmar.

摘要

背景:艾滋病毒污名是艾滋病毒预防、检测和治疗依从性的常见障碍,尤其是在缅甸等中低收入国家。然而,目前还没有经过验证的缅甸版污名量表。因此,我们将英语版的 40 项 Berger 的艾滋病毒污名量表和 7 项印度艾滋病毒污名量表改编成 47 项缅甸艾滋病毒污名量表,然后评估了该量表的心理测量特性。

方法:2020 年 1 月至 5 月,我们采用随机抽样方法,从一个拥有超过 10000 名艾滋病毒感染者/艾滋病患者(PLWHA)的封闭脸书小组中联系了 216 名符合条件的缅甸 PLWHA。有 156 名缅甸 PLWHA 完成了在线自我报告调查。

结果:通过探索性因素分析确定了量表的六因素结构,解释了总方差的 68.23%。删除 12 个项目后,35 项艾滋病毒污名量表的 Cronbach 's α 为 0.72 至 0.95。该量表与自我报告的抑郁和社会支持水平显著相关(r=0.60 和-0.77,p<0.01),证明了其结构效度。在 Rasch 分析中,该量表的个人可靠性为 3.40 和 1.53,分离指数为 0.92 和 0.70。每个项目的 infit 和 outfit 均方根范围为 0.68 至 1.40。未发现性别或教育水平上的差异项目功能。

结论:35 项缅甸版艾滋病毒污名量表具有良好的心理测量特性,可作为衡量缅甸 PLWHA 污名程度的工具。该工具可以帮助医疗保健提供者更好地了解污名在 PLWHA 中的运作方式,并在缅甸制定有针对性的减少污名干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/336f/8439000/41fe7cddc28b/12889_2021_11685_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/336f/8439000/41fe7cddc28b/12889_2021_11685_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/336f/8439000/41fe7cddc28b/12889_2021_11685_Fig1_HTML.jpg

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引用本文的文献

[1]
Measuring Stigma in Pediatric Oncology: A Cross-Sectional Analysis of Three Global Sites.

JCO Glob Oncol. 2025-1

[2]
Psychometric properties of stigma and discrimination measurement tools for persons living with HIV: a systematic review using the COSMIN methodology.

Syst Rev. 2024-4-27

[3]
Can social support mediate stigma and perceived stress in people live with human immunodeficiency virus?

AIDS Care. 2024-2

[4]
The Mediating Effects of Mindfulness on Perceived Stress From HIV Stigma in People Living With HIV in Myanmar: A Cross-sectional Study.

J Assoc Nurses AIDS Care.

本文引用的文献

[1]
Evaluation of peer-to-peer HIV counseling in Myanmar: a measure of knowledge, adherence, and barriers.

AIDS Care. 2022-6

[2]
Assessing depressive symptoms among people living with HIV in Yangon city, Myanmar: Does being a member of self-help group matter?

PLoS One. 2021

[3]
Differential item functioning for items in Berger's HIV Stigma Scale: an analysis of cohorts from the Indian, Swedish, and US contexts.

Qual Life Res. 2018-3-24

[4]
The Chinese Catquest-9SF: validation and application in community screenings.

BMC Ophthalmol. 2018-3-20

[5]
Shortened and Culturally Appropriate HIV Stigma Scale for Asians Living with HIV in the United States: Psychometric Analysis.

J Assoc Nurses AIDS Care. 2018-2-19

[6]
Development of a 12-item short version of the HIV stigma scale.

Health Qual Life Outcomes. 2017-5-30

[7]
90-90-90-Plus: Maintaining Adherence to Antiretroviral Therapies.

AIDS Patient Care STDS. 2017-5

[8]
Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar.

BMC Public Health. 2017-5-5

[9]
Evolution of the health sector response to HIV in Myanmar: progress, challenges and the way forward.

J Virus Erad. 2016-11-28

[10]
HIV care in Yangon, Myanmar; successes, challenges and implications for policy.

AIDS Res Ther. 2017-3-4

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