The Pregnant Women with HIV Attitude Scale: development and initial psychometric evaluation

Tools to measure HIV knowledge, attitudes & practices (KAPs) in healthcare providers: a systematic review

Healthcare providers' knowledge, attitudes and practices (KAPs) related to HIV are important determinants of quality of care provided to HIV/AIDS patients. Most studies have focussed on low- and middle-income countries (LMIC) with far fewer conducted within high-income countries, where the epidemiology of HIV is typically distinct from low- and middle-income countries. As part of a larger study, we wanted to measure HIV-KAPs in healthcare providers in Australia. A systematic search was conducted to identify and evaluate existing tools designed to measure HIV-related KAPs among healthcare providers in higher-income countries. In total, eight instruments were identified. The instruments drew upon adapted forms of existing HIV-related KAPs and stigma theories and were developed based on a range of methodological designs and for different cadre of healthcare workers. The extent to which psychometric properties for each tool were evaluated varied widely. Further research with more robust methodological and psychometric rigour is required for adequate measurement of KAP among health professionals specific to HIV, so associated training needs, patient experiences and health outcomes can potentially be enhanced.

Validation of 2 Spanish-Language Scales to Assess HIV-Related Stigma in Communities

We report the psychometric properties of 2 Spanish-language scales designed to measure (1) opinions about HIV in the community and particularly among health care workers and (2) observed acts of stigma toward people living with HIV/AIDS (PLWHA) by health care workers. The Opinions about HIV Scale included 3 components (policy, avoidance, and empathy) and 9 items, while an adapted version of the HIV/AIDS Stigma Instrument-Nurse, designed to capture acts of stigma, included 2 components (discrimination related to clinical care and refusal to share or exchange food/gifts). Scales demonstrated good reliability and construct validity. Relative to community health workers, treatment supporters were more likely to have stigmatizing opinions related to avoidance and empathy. We offer 2 Spanish-language scales that could be used to identify populations with high levels of stigmatizing opinions and behaviors toward PLWHA. Formal training of health care workers, especially treatment supporters, may raise awareness and reduce stigma toward HIV.

Judgements regarding the acceptability of childbearing and parental fitness made towards women living with HIV

This study examines the societal perceptions and judgements made towards HIV-positive pregnant women when compared with those targeting pregnant women with other medical conditions. One hundred and sixty participants (124 female) were randomly assigned to one of four experimental conditions defined by specific medical condition of the pregnant woman in the vignette (HIV/AIDS, obesity, lung cancer or diabetes). Participants were asked to respond to a variety of items gauging their reaction to the woman and her pregnancy subsequent to reading the scenario. As expected, participants were least approving of the pregnancy of the woman with HIV/AIDS, and they rated her as a less fit parent than the women with the other medical conditions. Subsequent analyses revealed that concern for the health of the child and attributions of responsibility/blame for the medical condition did not account for the differential reactions to the pregnant woman with HIV/AIDS. These findings corroborate the felt stigma and prejudicial attitudes reported by HIV-positive mothers.