Stigma, Secrecy, and Discrimination: Ethnic/Racial Differences in the Concerns of People Living with HIV/AIDS
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The HIV Stigma Scale is a measure that assesses stigmatization perceived and experienced by people living with HIV/AIDS (PLWHA). Using Item Response Theory (IRT) methodologies, the present study examined HIV Stigma Scale responses from 224 Black and 317 White PLWHA to determine whether cross-cultural differences exist in responses to items of the scale. IRT analysis revealed that eleven out of forty items functioned differently across groups. Black respondents had a higher probability of indicating greater stigmatization on items that described situations in which others discriminated against them, and White respondents had a higher probability of indicating greater stigmatization on items that described a resolve to keep their status a secret and fears of interpersonal rejection. These differences suggest that PLWHA have different experiences of stigma based on their ethnic/racial background, either because of cultural differences or the ways in which the participants interpreted items of the HIV Stigma Scale.
KeywordsHIV/AIDS Item Response Theory Measurement Stigma Cross-cultural
This study was supported in part by an Academy for Educational Development/Ford Foundation grant awarded to John Pryor and Bambi Gaddist. Deepa Rao is supported by a National Institute on Disability and Rehabilitation Research (NIDRR) Advanced Rehabilitation Research Training grant (H133P030002).
The authors would like to thank Elizabeth Hahn, M.A. and Randall Horton, Ph.D. for their helpful comments on earlier drafts of this article. The authors also thank Letitia Johnson-Arnold for her contributions in collecting the data from South Carolina participants. These results were also presented at the 16th International AIDS Conference in Toronto, Canada.
- Anderson, R. N., & Smith, B. L. (2005). Deaths: leading causes for 2002. National Vital Statistics Reports, 53(17), 67–70.Google Scholar
- Black, B. P., & Miles, M. S. (2002). Calculating the risks and benefits of disclosure in African American women who have HIV. JOGNN–Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(6), 688–697.Google Scholar
- Brooks, R. A., Etzel, M. A., Hinojos, E., Henry, C. L., & Perez, M. (2005). Preventing HIV among Latino and African American gay and bisexual men in a context of HIV-related stigma, discrimination, and homophobia: perspectives of providers. AIDS Patient Care and STDs, 19(11), 737–744.PubMedCrossRefGoogle Scholar
- CDC (Centre for Disease Control and Prevention). (2004). HIV/AIDS Surveillance Report: Cases of HIV infection and AIDS in the United States.Google Scholar
- Crandall, C. S. (1991). Multiple stigma and AIDS: Illness stigma and attitudes toward homosexuals and IV drug users in AIDS-related stigmatization. Journal of Community and Applied Social Psychology, (2), 165–172.Google Scholar
- Hambleton (2006). Good Practices for Identifying Differential Item Functioning. Medical Care, 44(11, Supplement 3), S182–S188.Google Scholar
- Hambleton, S. H., & Rogers, H. (1991). Fundamentals of Item Response Theory. Newbury Park, CA: Sage Publications, Inc.Google Scholar
- Hudgens, S., Dineen, K., Webster, K., Lai, J -S., & Cella, D. (2004). Assessing Statistically and Clinically Meaningful Construct Deficiency/Saturation: Recommended Criteria for Content Coverage and Item Writing. Rasch Measurement Transactions, 17, 954–955.Google Scholar
- Kalichman, S. (1998). Understanding AIDS. (2nd edn.). Washington, D.C.: American Psychological Association.Google Scholar
- Linacre, J. M. (1994). Sample Size and Item Calibration Stability. Rasch Measurement Transactions, 7(4), 328.Google Scholar
- Linacre, J. M. (2005). A User’s Guide to WINSTEPS, MINISTEP, Rasch-Model Computer Programs. Chicago: John M. Linacre.Google Scholar
- Pedhazur, E. J. (1997). Multiple Regression in Behavioral Research. New York: Harcourt Brace College Publishers.Google Scholar
- SPSS. (2002). SPSS for Windows, Rel. 11.5.1. Chicago: SPSS Inc.Google Scholar
- Tourangeau, R. (1984). Cognitive sciences and survey methods. In T. Jabine, M. Straf, J. Tanur & R. Tourageau (Eds.), Cognitive Aspects of Survey Methodology: Building a Bridge Between Disciplines (pp. 73–101). Washington, DC: National Academy Press.Google Scholar
- Treisman, G., & Angelino, A. (2004). The Psychiatry of AIDS. Baltimore: Johns Hopkins University Press.Google Scholar
- Willis, G. B. (1999). Cognitive Interviewing: A “How To” Guide, From the short course “Reducing Survey Error through Research on the Cognitive and Decision Processes in Surveys”. Paper presented at the Meeting of the American Statistical Association.Google Scholar
- Zumbo, B. (1999). A Handbook on the Theory and Methods of Differential Item Functioning (DIF): Logistic Regression Modeling as a Unitary Framework for Binary and Likert-Type (Ordinal) Item Scores. Ottawa, ON: Directorate of Human Resources Research and Evaluation, Department of National Defense.Google Scholar