Mi Tianyue, Yang Xueying, Lan Guanghua, Qiao Shan, Shen Zhiyong, Zhou Yuejiao, Li Xiaoming
Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina, Columbia, SC, United States.
Guangxi Center for Disease Control and Prevention, Nanning, China.
Front Psychol. 2025 Apr 25;16:1510034. doi: 10.3389/fpsyg.2025.1510034. eCollection 2025.
Measurement invariance ensures that scales used in research measure the same constructs across different groups. As HIV-related stigma scales are increasingly used in studies involving men who have sex with men (MSM) and non-MSM populations, it is crucial to evaluate the equivalence of these measures. This study examines the measurement invariance of internalized, anticipated, and enacted HIV-related stigma scales between MSM and non-MSM populations in China.
Data were derived from two studies: a prospective cohort study with 193 MSM and 579 non-MSM, and a cross-sectional survey of 402 MSM. Participants completed the 8-item internalized, 9-item anticipated, and 16-item enacted HIV-related stigma scales. Confirmatory factor analysis was used to test measurement invariance by progressively adding equality constraints to the models for each stigma dimension.
Partial scalar measurement invariance was achieved for the internalized stigma scale, allowing the intercepts of items 2, 3, and 6 to vary (χ = 89.32, = 43; CFI = 0.986; TLI = 0.981; RMSEA = 0.043, 95%CI [0.030, 0.056]; SRMR = 0.033), indicating that the zero points of item 2 ("I feel ashamed of having HIV"), item 3 ("Having HIV makes me feel unclean"), and item 6 ("I feel guilty because I have HIV") were different between MSM and non-MSM. Partial residual measurement invariance was established for the anticipated stigma scale by allowing the residuals of item 2 to vary (χ = 93.57, = 66; CFI = 0.994; TLI = 0.993; RMSEA = 0.027, 95%CI [0.012, 0.038]; SRMR = 0.022), indicating that the item variance that could not be explained by the factor was different between MSM and non-MSM. For the enacted stigma scale, partial scalar invariance was achieved by allowing the threshold of item 7 to vary (χ = 314.74, = 219; CFI = 0.987; TLI = 0.986; RMSEA = 0.027, 95%CI [0.020, 0.034]; SRMR = 0.088), indicating that the threshold of item 7 was different between MSM and non-MSM.
The study supports the use of these HIV-related stigma scales for comparing MSM and non-MSM populations, though caution is needed as some items demonstrated partial measurement invariance. These findings provide a foundation for future research and interventions aimed at reducing HIV-related stigma across diverse groups.
测量不变性确保研究中使用的量表在不同群体中测量相同的构念。随着与艾滋病相关的污名化量表越来越多地用于涉及男男性行为者（MSM）和非男男性行为者人群的研究中，评估这些测量方法的等效性至关重要。本研究考察了中国男男性行为者和非男男性行为者人群中内化的、预期的和实际发生的与艾滋病相关的污名化量表的测量不变性。
数据来自两项研究：一项对193名男男性行为者和579名非男男性行为者的前瞻性队列研究，以及一项对402名男男性行为者的横断面调查。参与者完成了8项内化的、9项预期的和16项实际发生的与艾滋病相关的污名化量表。通过逐步向每个污名维度的模型添加等式约束，使用验证性因素分析来测试测量不变性。
内化污名化量表实现了部分标量测量不变性，允许第2、3和6项的截距变化（χ = 89.32， = 43；CFI = 0.986；TLI = 0.981；RMSEA = 0.043，95%CI [0.030, 0.056]；SRMR = 0.033），表明第2项（“我为感染艾滋病毒感到羞愧”）、第3项（“感染艾滋病毒让我觉得不干净”）和第6项（“我因感染艾滋病毒而感到内疚”）在男男性行为者和非男男性行为者之间的零点不同。通过允许第2项的残差变化，预期污名化量表建立了部分残差测量不变性（χ = 93.57， = 66；CFI = 0.994；TLI = 0.993；RMSEA = 0.027，95%CI [0.012, 0.038]；SRMR = 0.022），表明男男性行为者和非男男性行为者之间无法由该因素解释的项目方差不同。对于实际发生的污名化量表，通过允许第7项的阈值变化实现了部分标量不变性（χ = 314.74， = 219；CFI = 0.987；TLI = 0.986；RMSEA = 0.027，95%CI [0.020, 0.034]；SRMR = 0.088），表明第7项在男男性行为者和非男男性行为者之间的阈值不同。
该研究支持使用这些与艾滋病相关的污名化量表来比较男男性行为者和非男男性行为者人群，不过由于一些项目显示出部分测量不变性，仍需谨慎。这些发现为未来旨在减少不同群体中与艾滋病相关污名化的研究和干预措施奠定了基础。
