Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Department of Social Sciences, Pwani University, Box 195, Kilifi, Kenya.
Glob Health Res Policy. 2021 Dec 10;6(1):49. doi: 10.1186/s41256-021-00229-9.
BACKGROUND: There is a dearth of instruments that have been developed and validated for use with children living with HIV under the age of 17 years in the Kenyan context. We examined the psychometric properties and measurement invariance of a short version of the Berger HIV stigma scale administered to perinatally HIV-infected adolescents in a rural setting on the Kenyan coast. METHODS: A cross-sectional study was conducted among 201 perinatally HIV-infected adolescents aged 12-17 years between November 2017 and October 2018. A short version of the Berger HIV stigma scale (HSS-40) containing twelve items (HSS-12) covering the four dimensions of stigma was evaluated. The psychometric assessment included exploratory factor analysis, confirmatory factor analysis (CFA), and multi-group CFA. Additionally, scale reliability was evaluated as internal consistency by calculating Cronbach's alpha. RESULTS: Evaluation of the reliability and construct validity of the HSS-12 indicated insufficient reliability on three of the four subscales. Consequently, Exploratory Factor Analysis (EFA) was conducted to identify problematic items and determine ways to enhance the scale's reliability. Based on the EFA results, two items were dropped. The Swahili version of this new 10-item HIV stigma scale (HSS-10) demonstrated excellent internal consistency with a Cronbach alpha of 0.86 (95% confidence interval (CI) 0.84-0.89). Confirmatory Factor Analysis indicated that a unidimensional model best fitted the data. The HSS-10 presented a good fit (overall Comparative Fit Index = 0.976, Tucker Lewis Index = 0.969, Root Mean Square Error of Approximation = 0.040, Standardised Root Mean Residual = 0.045). Additionally, multi-group CFA indicated measurement invariance across gender and age groups at the strict invariance level as ΔCFI was ≤ 0.01. CONCLUSION: Our findings indicate that the HSS-10 has good psychometric properties and is appropriate for evaluating HIV stigma among perinatally HIV-infected adolescents on the Kenyan coast. Further, study results support the unidimensional model and measurement invariance across gender and age groups of the HSS-10 measure.
背景：在肯尼亚背景下，针对年龄在 17 岁以下的感染艾滋病毒的儿童，尚未开发和验证过用于此类人群的工具。我们在肯尼亚沿海农村地区，对感染艾滋病毒的围产期青少年进行了一项横断面研究，检测了伯格艾滋病毒耻辱量表的一个简短版本的心理测量特性和测量不变性。
方法：2017 年 11 月至 2018 年 10 月期间，我们对 201 名年龄在 12-17 岁之间的围产期感染艾滋病毒的青少年进行了一项横断面研究。评估了伯格艾滋病毒耻辱量表的简短版本（HSS-40），其中包含涵盖耻辱的四个维度的 12 个项目（HSS-12）。心理测量评估包括探索性因子分析、验证性因子分析（CFA）和多组 CFA。此外，通过计算 Cronbach 的 alpha 来评估量表的可靠性作为内部一致性。
结果：对 HSS-12 的可靠性和结构效度的评估表明，四个分量表中的三个分量表的可靠性不足。因此，进行了探索性因素分析（EFA），以确定有问题的项目，并确定提高量表可靠性的方法。基于 EFA 的结果，删除了两个项目。斯瓦希里语版本的新的 10 项艾滋病毒耻辱量表（HSS-10）具有出色的内部一致性，Cronbach 的 alpha 为 0.86（95%置信区间（CI）为 0.84-0.89）。验证性因子分析表明，一个单维模型最适合数据。HSS-10 表现出良好的拟合度（总体比较拟合指数=0.976，塔克-刘易斯指数=0.969，均方根误差逼近值=0.040，标准化均方根残差=0.045）。此外，多组 CFA 表明，在严格不变性水平上，性别和年龄组之间的测量不变性，ΔCFI 小于等于 0.01。
结论：我们的研究结果表明，HSS-10 具有良好的心理测量特性，适用于评估肯尼亚沿海地区感染艾滋病毒的围产期青少年的艾滋病毒耻辱感。此外，研究结果支持 HSS-10 测量的一维模型和性别及年龄组之间的测量不变性。
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