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Evidence for the Reliability and Validity of the Internalized AIDS-Related Stigma Scale in Rural Uganda

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Abstract

HIV infection remains highly stigmatized throughout sub-Saharan Africa despite the increasing availability of treatment. HIV-related stigma is commonly described to be highly prevalent in East Africa, but none of these studies have employed validated scales for measurement. We used data from 456 people living with HIV/AIDS in rural Uganda to validate the six-item Internalized AIDS-Related Stigma Scale. The scale demonstrated acceptable internal consistency (Cronbach’s alpha = 0.73) and time stability. Exploratory factor analysis indicated the presence of a single factor. Construct validity was supported by observations that the scale was correlated with related constructs such as depression and mental health-related quality of life. The scale was able to discriminate between groups of persons who were different in terms of treatment status and their experience of HIV-related self-blame. Taken together, these findings suggest that the Internalized AIDS-Related Stigma Scale may be a useful tool for socio-behavioral HIV research.

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Acknowledgments

We thank the Uganda AIDS Rural Treatment Outcomes study participants who made this study possible by sharing their experiences; and Doreen Akello, Marcy Mutumba, Christine Ngabirano, Ruth Ssentongo, and Florence Turyashemererwa for research assistance. Jessica E. Haberer, Elias Kumbakumba, and Jude Senkungu provided invaluable input on all aspects of study design and implementation. While these individuals are acknowledged for their assistance, no endorsement of manuscript contents or conclusions should be inferred.

Funding

The study was funded by U.S. National Institutes of Health R01 MH-054907, K23 MH-79713, and P30 AI27763. The authors acknowledge the following additional sources of salary support: the Burke Family Foundation, K23 MH-096620, and K24 MH-087227.

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Authors and Affiliations

  1. Center for Global Health, Massachusetts General Hospital, Room 1529-E3, 100 Cambridge Street, 15th Floor, Boston, MA, 02114, USA

    Alexander C. Tsai & David R. Bangsberg

  2. The Chester M. Pierce MD Division of Global Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Alexander C. Tsai

  3. Division of HIV/AIDS and Positive Health Program, University of California at San Francisco, San Francisco, CA, USA

    Sheri D. Weiser & Peter W. Hunt

  4. Department of Medicine, University of California at San Francisco, San Francisco, CA, USA

    Wayne T. Steward

  5. Mbarara University of Science and Technology, Mbarara, Uganda

    Nozmo F. B. Mukiibi, Annet Kawuma, Annet Kembabazi, Conrad Muzoora & David R. Bangsberg

  6. Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA

    Jeffrey N. Martin

  7. Harvard Medical School, Boston, MA, USA

    David R. Bangsberg

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  1. Alexander C. Tsai
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  2. Sheri D. Weiser
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Correspondence to Alexander C. Tsai.

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Tsai, A.C., Weiser, S.D., Steward, W.T. et al. Evidence for the Reliability and Validity of the Internalized AIDS-Related Stigma Scale in Rural Uganda. AIDS Behav 17, 427–433 (2013). https://doi.org/10.1007/s10461-012-0281-3

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