Eschliman Evan L, Liu Yuexuan, Rahmah Asri A, Philip Briyanna, Hoang Dung T, Kokaze Haruka, Khoshnam Nasim, Dunkel Emily, Ye Vivian R, Choe Karen, Poku Ohemaa B, Alvarez Gloria, Nguyen Trang, Nguyen Nam Truong, Shelley Donna, Yang Lawrence H
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA.
AIDS Care. 2025 Jun 26:1-17. doi: 10.1080/09540121.2025.2521801.
People living with HIV have disproportionate cancer risk and are a priority population for cancer prevention and control efforts globally, including in Vietnam. HIV-related and cancer stigma independently and intersectionally hinder access to and uptake of prevention and treatment. Using formative qualitative research that used the "What Matters Most" theoretical framework and cognitive interviewing, we developed three culturally-tailored stigma scales for people living with HIV in Hanoi, Vietnam (i.e., for anticipated intersectional HIV-related and cancer stigma, internalized HIV-related stigma, and public cancer stigma [i.e., negative community attitudes]). Scales were administered to 100 people living with HIV alongside existing widely-used stigma scales and measures of cancer prevention-related constructs. This initial psychometric validation supported that each scale has two subscales reflecting how cultural aspects both shape and protect against stigma, strong reliability (ranging from = 0.76-0.91, = 0.78-0.91), and strong convergent validity with corresponding existing scales for internalized HIV-related stigma and public cancer stigma. The culturally-tailored intersectional and cancer-only scales were correlated at least as highly with the measured cancer prevention-related constructs compared to the existing public cancer stigma scale. Culturally-tailored, intersectional scales could help monitor and address stigma, ultimately promoting HIV and cancer prevention, control, and treatment.
艾滋病毒感染者患癌症的风险更高,是全球癌症预防和控制工作的重点人群,包括在越南。与艾滋病毒相关的耻辱感和癌症耻辱感分别且相互交织地阻碍了预防和治疗的获取与接受。我们运用采用“最重要的是什么”理论框架和认知访谈的形成性定性研究,为越南河内的艾滋病毒感染者开发了三种针对文化定制的耻辱感量表(即针对预期的与艾滋病毒相关和癌症的交叉耻辱感、内化的与艾滋病毒相关的耻辱感以及公众对癌症的耻辱感[即社区负面态度])。这些量表与现有的广泛使用的耻辱感量表以及癌症预防相关构念的测量方法一起,施用于100名艾滋病毒感染者。这一初步的心理测量学验证支持了每个量表都有两个子量表,反映了文化方面如何塑造耻辱感并起到抵御耻辱感的作用,具有很强的信度(范围从=0.76 - 0.91,=0.78 - 0.91),并且与内化的与艾滋病毒相关的耻辱感和公众对癌症的耻辱感的相应现有量表具有很强的收敛效度。与现有的公众对癌症的耻辱感量表相比,针对文化定制的交叉量表和仅针对癌症的量表与所测量的癌症预防相关构念的相关性至少同样高。针对文化定制的交叉量表有助于监测和解决耻辱感问题,最终促进艾滋病毒和癌症的预防、控制及治疗。
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