Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America.
PLoS One. 2023 Oct 19;18(10):e0292642. doi: 10.1371/journal.pone.0292642. eCollection 2023.
People who use drugs (PWUD) experience stigma from multiple sources due to their drug use. HIV seroprevalence for PWUD in Tanzania is estimated to range from 18 to 25%. So, many PWUD will also experience HIV stigma. Both HIV and drug use stigma have negative health and social outcomes, it is therefore important to measure their magnitude and impact. However, no contextually and linguistically adapted measures are available to assess either HIV or drug use stigma among PWUD in Tanzania. In response, we translated and culturally adapted HIV and drug use stigma measures among Tanzanian PWUD and described that process in this study.
This was a cross-sectional study. We translated and adapted existing validated stigma measures by following a modified version of Wild's ten steps for translation and adaptation. We also added new items on stigmatizing actions that were not included in the original measures. Following translation and back translation, we conducted 40 cognitive debriefs among 19 PWUD living with and 21 PWUD not living with HIV in Dar es Salaam to assess comprehension of the original and new items. For challenging items, we made adaptations and repeated cognitive debriefs among ten new PWUD participants where half of them were living with HIV.
Most of the original items (42/54, 78%), response options and all items with new 12 stigmatizing actions were understood by participants. Challenges included response options for a few items; translation to Swahili; and differences in participants' interpretation of Swahili words. We made changes to these items and the final versions were understood by PWUD participants.
Drug use and HIV stigma measures can successfully be translated and culturally adapted among Tanzanian PWUD living with and without HIV. We are currently conducting research to determine the stigma measures' psychometric properties and we will report the results separately.
由于吸毒，吸毒者（PWUD）会受到来自多个方面的污名化。据估计，坦桑尼亚吸毒者中的 HIV 感染率在 18%至 25%之间。因此，许多吸毒者也会经历 HIV 污名化。HIV 污名和吸毒污名都对健康和社会有负面影响，因此衡量其严重程度和影响非常重要。然而，坦桑尼亚目前没有适用于评估吸毒者 HIV 污名和吸毒污名的上下文和语言适应性测量工具。有鉴于此，我们翻译并改编了针对坦桑尼亚吸毒者的 HIV 污名和吸毒污名测量工具，并在本研究中描述了这一过程。
这是一项横断面研究。我们遵循 Wild 的翻译和改编的十步准则，对现有的经过验证的污名测量工具进行了翻译和改编。我们还增加了一些在原始测量工具中未包含的关于污名化行为的新条目。在翻译和回译之后，我们在达累斯萨拉姆的 19 名 HIV 感染者和 21 名未感染者中进行了 40 次认知测试，以评估对原始和新条目理解情况。对于有挑战的条目，我们在另外 10 名新吸毒者中进行了改编和重复认知测试，其中一半人感染了 HIV。
大多数原始条目（42/54，78%）、应答选项和所有带有 12 项新污名化行为的条目都被参与者理解。挑战包括一些条目的应答选项；斯瓦希里语的翻译；以及参与者对斯瓦希里语单词的不同解释。我们对这些条目进行了更改，最终版本得到了吸毒者参与者的理解。
吸毒和 HIV 污名测量工具可以在坦桑尼亚有 HIV 感染者和无 HIV 感染者中成功地进行翻译和文化改编。我们目前正在进行研究以确定污名测量工具的心理测量学特性，并将分别报告结果。
