Development and Validation of HIV/AIDS Stigma and Discrimination Scale in Southeast Iran: The General Population Viewpoint

Validity and Reliability of the Human Immunodeficiency Virus-Related Stigma Questionnaire in Persian

Background: It was aimed to adapt a 12-item questionnaire into Persian among people living with human immunodeficiency virus (PLHIV) in Markazi province. Material and Methods: Content validity was evaluated based on the opinions of the relevant experts, and by calculating the scale-level content validity index (S-CVI) and the item-level content validity index (I-CVI). Reliability was assessed via test-retest, intraclass correlation coefficient (ICC), and Cronbach's alpha. Results: The obtained scores on clarity and relevancy (I-CVI) ranged from 0.9 to 1. The S-CVI also had an acceptable validity of 0.99. The Cronbach's alpha index of the whole questionnaire was 0.84 and ranged from 0.69 to 0.82 for subscales. The ICC in test-retest for all questionnaires was 0.88 and for subscales ranged from 0.77 to 0.88. Conclusion: The Persian version of the 12-item human immunodeficiency virus-related stigma questionnaire was found to be, in addition to being short and comprehensive, acceptable reliability and high validity to use in order to determine the stigma related to Persian-speaker PLHIV.

Internalized HIV-related stigma in women of color obtaining care at an HIV specialty center in Los Angeles County, California

The current study examined the role of internalized HIV-related stigma in antiretroviral therapy adherence, viral load, and retention in care among women of color living with HIV in Los Angeles County, California. African American and Hispanic/Latino women 18 years of age and older completed a one-time brief survey between September 2017 and February 2018. Descriptive statistics, and univariable and multivariable logistic regressions were used to analyze the data. Seventy-six participants enrolled in the study and 74 completed the entire survey. Seventy-six percent of respondents were Hispanic/Latino, 24% were African American, 71% were unemployed, and 54% had less than a high school education. Thirty-five percent were defined as having "high" stigma with a score in the upper quartile of the scale. Being unemployed, having a high school education or less, and not meeting the Health Resources and Services Administration's annual retention in care measure were associated with "high" stigma. When controlling for education and employment status, those reporting "high" stigma vs. "low" stigma were 18.8 times more likely to not meet the criteria for annual retention in care (OR = 18.8, 95% CI = 1.9-189.2, p = 0.013). Stigma-reduction interventions targeting healthcare settings may be necessary to improve patient retention and engagement in care.

Psychometric properties of modified MOS social support survey 5-item (MSSS-5-item) among Iranian older adults

BACKGROUND

Social support is a key factor in public health. Since the precise evaluation of it is critical, the current study has been developed to evaluate the psychometric properties of the MOS-SSS questionnaire's abbreviated form (MSSS-5-item) among the Iranian older adults.

METHODS

This cross-sectional and methodological study was conducted on 420 community older adults (age ≥ 60) through random multi-stage sampling. The questionnaire was first translated into Persian through the Forward & Backward method based on WHO guidelines. Next, the validity of scales was investigated by calculating face validity, content validity, Known-group validity, explanatory factor analysis, and confirmatory factor analysis indices. The reliability of the questionnaire was calculated by internal consistency, test-retest, and absolute reliability. Moreover, the scalability of the questionnaire was checked through the Mokken scale analysis. The software packages SPSS version 22, AMOS version 22, and R (Mokken package) were employed to analyze the data.

RESULTS

the face validity was conducted using interviews with older adults and gathering the specialists' opinions. Then, the items were grammatically and lexically corrected accordingly. The CVI index of the overall scale was 0.94, and for every single item above 0.89. The results of the independent t-test showed that the current questionnaire well distinguished between the older adults who do and do not feel lonely (p < 0.001). Two components were recognized according to the explanatory factor analysis. They together explained 67.78% of the total variance of the questionnaire. The CFA showed that the two-factor model had acceptable fit indices. The questionnaire had desirable internal consistency (α = 0.78), stability (ICC = 0.98), and absolute reliability (SEM = 0.56, MDC = 1.57). Furthermore, the Mokken scale proved that MSSS-5-item was a strong scale (H = 0.51, se = 0.03).

CONCLUSION

The present study results showed that the MSSS-5-item questionnaire had suitable validity and reliability to be used among Iranian older adults.

"Men Are Scared That Others Will Know and Will Discriminate Against Them So They Would Rather Not Start Treatment." Perceptions of Heterosexual Men on HIV-Related Stigma in HIV Services in Blantyre, Malawi

BACKGROUND

Although the concept of treatment as prevention has generated optimism that an AIDS-free generation is within reach, the success of this approach centers upon early diagnosis and linkages to care for people living with HIV. Unfortunately, people continue to present for HIV care at late stages of disease and HIV-related stigma has been recognized as the major impediment to HIV prevention and treatment efforts. Given the relevance of addressing stigma to improve access and utilization of HIV services among men, this secondary analysis assessed perceptions of heterosexual men in HIV-related stigma on HIV testing and ART services in Blantyre District.

METHODS

Purposive sampling was done with maximum variation which included men with unknown statuses, newly diagnosed with HIV infection and not yet on ARVs and those with HIV infection on ART. These participants were varied according to age and area of residency and included men from urban, semi urban and rural areas. Health care workers were included depending in the participation in the provision of HIV services. Eighteen (18 IDIs) and sixteen (16) KIIs were done at private facilities and a total of twenty (20) IDS and seventeen (17) KIIs interviews were conducted at public facilities and fourteen (14) FGD were conducted at public facilities as well. The data were collected from January to July 2017 and March to September 2018.

RESULTS

Men perceived that there are barriers and enablers that influence men from accessing HIV testing and ART services. These factors include individuals, family, community and workplace. The surroundings can be a person, community and a family and it plays an integral part in ones' decision to get tested or initiate on ART. At all these levels, men would navigate the options of accessing the services while risking stigma and discrimination.

CONCLUSION

HIV-related stigma exists and impedes access to HIV testing and ART services in men. Men preferred private hospitals to public facilities because of their ability to maintain respect to privacy and confidentiality to their client's. Imitating these policies into the public hospitals can help to improve the perception of HIV-related stigma in heterosexual men.