Byramjee-Jeejeebhoy Government Medical College - Johns Hopkins University Clinical Research Site, Pune, India.
Department of Epidemiology, McGill University, 2001 McGill College, Suite 1200, Montreal, QC, H3A 1G1, Canada.
Health Qual Life Outcomes. 2022 Jul 31;20(1):119. doi: 10.1186/s12955-022-02030-9.
HIV-related stigma is associated with poor quality of life and poor healthcare-seeking behaviours in young people living with HIV (YPLHIV) and young people affected by HIV (YPAHIV). India has an estimated 120,000 YPLHIV and 4 million YPAHIV, but efforts to measure HIV-related stigma in them are sparse, impeded by the lack of measuring instruments. Here, we describe the development of the Pune HIV-Stigma Scale (PHSS) and modified-PHSS to measure HIV-related stigma among YPLHIV and YPAHIV, respectively, in India.
We used data from a mental health study for YPLHIV and YPAHIV aged 15-25 years, conducted at Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospitals, Pune, India, between August 2018 and June 2021. Findings from multiple confirmatory factor analyses and cognitive interviews guided the development of the 12-item PHSS. The modified-PHSS was developed by confirming the structure of the PHSS for YPAHIV. Convergent validity with Center for Epidemiological Studies Depression (CES-D) and UCLA Loneliness scales was assessed using Spearman's correlation coefficients.
Model fit indices were good for both the PHSS (χ = 65.0, df = 48, p value: 0.052; root mean square error of approximation (RMSEA): 0.054; comparative fit index (CLI): 0.980; Tucker-Lewis index (TLI): 0.972; and standardized root mean square residual (SRMR): 0.067), and the modified-PHSS (χ = 56.9, df = 48, p value: 0.176; RMSEA: 0.045; CLI: 0.983; TFI: 0.976, and SRMR: 0.078). Spearman's correlation coefficients indicated low to moderate convergent validity (ρ: 0.03-0.52) across different subscales of the PHSS and modified-PHSS. Cronbach's alpha for the PHSS was 0.82 and for the modified-PHSS 0.81.
We developed the first scales to measure HIV-related stigma among YPLHIV and YPAHIV in India. These concise scales can facilitate measurement of HIV-related stigma more frequently in research studies. We recommend that they be tested in different Indian languages.
艾滋病毒相关耻辱感与艾滋病毒感染者青年（YPLHIV）和受艾滋病毒影响的青年（YPAHIV）的生活质量差和寻求医疗保健行为不佳有关。印度估计有 12 万名 YPLHIV 和 400 万 YPAHIV，但由于缺乏衡量工具，衡量他们的艾滋病毒相关耻辱感的努力很少。在这里，我们描述了普纳艾滋病毒耻辱量表（PHSS）和改良-PHSS 的开发，分别用于衡量印度 YPLHIV 和 YPAHIV 中的艾滋病毒相关耻辱感。
我们使用了 2018 年 8 月至 2021 年 6 月在印度浦那的拜拉姆吉·杰杰布霍伊政府医学院和萨松综合医院进行的一项针对 15-25 岁 YPLHIV 和 YPAHIV 的心理健康研究的数据。来自多项验证性因素分析和认知访谈的结果指导了 12 项 PHSS 的开发。改良-PHSS 通过确认 PHSS 对 YPAHIV 的结构而开发。使用 Spearman 相关系数评估与流行病学研究抑郁量表（CES-D）和加州大学洛杉矶分校孤独量表的聚合效度。
PHSS 的模型拟合指标良好（χ=65.0，df=48，p 值：0.052；近似均方根误差（RMSEA）：0.054；比较拟合指数（CLI）：0.980；Tucker-Lewis 指数（TLI）：0.972；标准化均方根残差（SRMR）：0.067），改良-PHSS 的模型拟合指标也良好（χ=56.9，df=48，p 值：0.176；RMSEA：0.045；CLI：0.983；TFI：0.976，SRMR：0.078）。PHSS 和改良-PHSS 不同子量表之间的 Spearman 相关系数表明聚合效度较低至中等（ρ：0.03-0.52）。PHSS 的 Cronbach's alpha 为 0.82，改良-PHSS 为 0.81。
我们开发了印度衡量 YPLHIV 和 YPAHIV 艾滋病毒相关耻辱感的第一批量表。这些简洁的量表可以更频繁地促进在研究中测量艾滋病毒相关耻辱感。我们建议在不同的印度语言中测试它们。
