在一家三级医疗机构中接受治疗的艾滋病病毒感染者的艾滋病耻辱感的心理评估：在加纳视角下对 Berger 艾滋病耻辱感量表的初步验证。
Psychometric assessment of HIV stigma in patients attending a tertiary facility: An initial validation of the Berger HIV stigma scale in a Ghanaian perspective.
机构信息
Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
Pharmacogenomics and Genomic Medicine Group, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
出版信息
PLoS One. 2023 Apr 27;18(4):e0282193. doi: 10.1371/journal.pone.0282193. eCollection 2023.
BACKGROUND
HIV-related stigma and discrimination are major challenges to people living with HIV (PLWHIV) and are due to misconceptions. Due to socioeconomic variations, there is increased stigma experienced by PLWHIV in sub-Saharan Africa (SSA). Stigma affects adherence to antiretroviral medications by PLWHIV and defeats the goal of achieving viral suppression. This study evaluated the Bergers HIV stigma scale in PLWHIV in Ghana regarding construct validity and reliability and assessed which aspect of stigma is critical for immediate redress.
METHODS
The Berger et al. HIV stigma scale (39 items) and some selected questions from HIV stigma and discrimination measurement tool of the International Centre for Research on Women, Washington, DC were administered to a cohort of PLWHIV in Ghana (n = 160). Clinico- demographic data was collected from their folders and verbally. The psychometric assessment included exploratory factor analysis whiles scale reliability was evaluated as internal consistency by calculating Cronbach's α.
RESULTS
The exploratory factor analysis suggested a four-factor solution which is like the original Berger HIV scale with sub-scales personalised stigma, disclosure concerns, negative self- image, and concerns with public attitudes. Items in the sub-scales personalised stigma (15- items), disclosure concerns (6), negative self-image (7) and concerns with public attitudes (6) were reduced compared to the original scale. Cronbach's α for the overall HIV stigma scale (34-items) was 0.808 whiles the sub-scales α ranged from 0.77 to 0.89. Analysis suggested the prevalence of a fundamental one-dimensional factor solution which yielded a 34-item scale after removing items for low factor loadings. Disclosure concerns was the highest ranked subscale although our study also found that about 65% of PLWHIV among our study participants had disclosed their status.
CONCLUSION
Our 34-item abridged Berger HIV stigma scale showed sufficient reliability with high Cronbach's α and construct validity. Disclosure concerns ranked high among the sub-scales on the scale. Exploring specific interventions and strategies to address stigma concerns in our population will aid in the reduction of HIV-related stigma and associated consequences.
背景
艾滋病毒相关的耻辱和歧视是艾滋病毒感染者（PLWHIV）面临的主要挑战，这些耻辱和歧视源于误解。由于社会经济的差异，撒哈拉以南非洲（SSA）的 PLWHIV 面临着更多的耻辱。耻辱感会影响 PLWHIV 对抗逆转录病毒药物的依从性，从而使实现病毒抑制的目标落空。本研究评估了加纳 PLWHIV 中 Berger 艾滋病毒耻辱量表的结构效度和信度，并评估了哪些耻辱方面需要立即纠正。
方法
Bergers HIV 耻辱量表（39 项）和华盛顿特区国际妇女研究中心的 HIV 耻辱和歧视测量工具中的一些选定问题被用于加纳的一组 PLWHIV（n=160）。从他们的文件夹和口头收集临床人口统计学数据。心理计量评估包括探索性因素分析，同时通过计算 Cronbach's α 来评估量表的可靠性。
结果
探索性因素分析表明，有四个因素的解决方案，类似于 Berger HIV 量表的原始版本，具有个性化耻辱、披露关注、消极自我形象和对公众态度的关注等子量表。与原始量表相比，个性化耻辱（15 项）、披露关注（6 项）、消极自我形象（7 项）和对公众态度的关注（6 项）子量表的项目有所减少。整个 HIV 耻辱量表（34 项）的 Cronbach's α 为 0.808，而子量表的 α 值范围在 0.77 到 0.89 之间。分析表明，存在一种基本的一维因子解决方案，在去除低因子负荷的项目后，得到了一个 34 项的量表。披露关注是排名最高的子量表，尽管我们的研究还发现，在我们的研究参与者中，大约 65%的 PLWHIV 已经披露了他们的状况。
结论
我们的 34 项 Bergers HIV 耻辱量表具有足够的可靠性，Cronbach's α 高，结构效度好。在量表的子量表中，披露关注排名最高。探索针对我们人群的耻辱问题的具体干预措施和策略，将有助于减少艾滋病毒相关的耻辱和相关后果。
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