Skip to main content

Advertisement

Log in

Cross-Cultural Validation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS) in China

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The study aimed to validate the Health Care Provider HIV/AIDS Stigma Scale among medical staff in China. The validation was conducted in four steps from March to December 2017: translation and back-translation; content validity test with six experts; test–retest reliability testing with 63 medical staff with 2 weeks interval; and structural validation with 349 medical staff from 52 hospitals with a convenience sample,using exploratory factor analysis,including principal component analysis and varimax rotation. The scale content validity index average was 0.88, while for test–retest reliability, the ICC was 0.87. Three factors of “discrimination”, “prejudice” and “stereotype” with 16 items were extracted and explained 59.61% variance. The Cronbach’s alpha value for the total scale was of 0.88, and for the three factors, the values were 0.89, 0.86 and 0.74, respectively. The discrimination factor showed identical means between Canadian medical students and Chinese medical staff, while the prejudice and stereotype factors had higher mean scores in the Chinese sample. The three-factor structure of Health Care Provider HIV/AIDS Stigma Scale was confirmed in Chinese medical staff with a simpler solution. This could provide a basis for trans-cultural application and comparison.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Srithanaviboonchai K, Stockton M, Pudpong N, et al. Building the evidence base for stigma and discrimination-reduction programming in Thailand: development of tools to measure healthcare stigma and discrimination. BMC Public Health. 2017;17(1):245.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Famoroti TO, Fernandes L, Chima SC. Stigmatization of people living with HIV/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study. BMC Medical Ethics. 2013;14(Suppl 1):S6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wu S, Li L, Wu Z, et al. A brief HIV stigma reduction intervention for service providers in China. AIDS Patient Care STDS. 2008;22(6):513–20.

    Article  PubMed  PubMed Central  Google Scholar 

  4. China Ministry of Health and UN Theme Group on HIV/AIDS in China. A joint assessment of HIV/AIDS prevention treatment and care in China. Beijing: China Ministry of Health; 2003.

    Google Scholar 

  5. Adams B. Locked doors: the human rights of people living with HIV/AIDS in China. New York: Human Rights Watch; 2003. p. 675–6.

    Google Scholar 

  6. Peng XU, Chen W, Lahong JU, et al. Evolution and perfection of the HIV/AIDS designated hospital system in China. Chin J Health Policy. 2015;5:67–72 (in Chinese).

    Google Scholar 

  7. Wagner AC, Hart TA, Mcshane KE, Margolese S, Girard TA. Health care provider attitudes and beliefs about people living with HIV: initial validation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS). AIDS Behav. 2014;18(12):2397–408.

    Article  PubMed  Google Scholar 

  8. Stein JA, Li L. Measuring HIV-related stigma among Chinese service providers: confirmatory factor analysis of a multidimensional scale. AIDS Behav. 2008;12(5):789–95.

    Article  PubMed  Google Scholar 

  9. Rutledge SE, Whyte J, Abell N, Brown KM, Cesnales NI. Measuring stigma among health care and social service providers: the HIV/AIDS Provider Stigma Inventory. Aids Patient Care Stds. 2011;25(11):673.

    Article  PubMed  Google Scholar 

  10. Windsor LC, Benoit E, Ream GL, Forenza B. The provider perception inventory: psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior. Aids Care. 2013;25(5):586–91.

    Article  PubMed  Google Scholar 

  11. Ahmadi K, Reidpath DD, Allotey P, Hassali MAA. A latent trait approach to measuring HIV/AIDS related stigma in healthcare professionals: application of mokken scaling technique. BMC Med Educ. 2016;16(1):155.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wang L, Ding Z, Qin Q, Cai C, Guo W, Cui Y. Characteristics of HIV transmission through heterosexual contact in China, 2008–2014. Zhonghua Liuxingbingxue Zazhi. 2015;36:1332–6.

    CAS  PubMed  Google Scholar 

  13. Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–77.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Tu YS. Development of discrimination related HIV/AIDS scale for health work. Kunming: Kunming Medical College; 2006 (in Chinese).

    Google Scholar 

  15. Patterson D, London L. International law, human rights and HIV/AIDS. Bull World Health Organ. 2002;80(12):964–9.

    PubMed  Google Scholar 

  16. Cao Y, Li X, Tao Y, et al. Development and evaluation of discrimination related HIV/AIDS scale for medical and nursing students. Chin J Dis Control Prev. 2013;12:017 (in Chinese).

    Google Scholar 

  17. Brown TA. Confirmatory factor analysis for applied research. 1st ed. New York: The Guilford Press; 2006.

    Google Scholar 

  18. Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489–97.

    Article  Google Scholar 

  19. Ferguson E, Cox T. Exploratory factor analysis: a users’ guide. Int J Sel Assess. 1993;1(2):84–94.

    Article  Google Scholar 

  20. Streiner DL, Norman G, Cairney J. Health measurement scales: a practical guide to their development and use. Oxford: Oxford University Press; 2015. p. 156.

    Book  Google Scholar 

  21. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2015;17(2):268–74.

    Article  Google Scholar 

  22. Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35(6):382–5.

    Article  CAS  PubMed  Google Scholar 

  23. Fleiss JL, Cohen J. The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ Psychol Meas. 1973;33(3):613–9.

    Article  Google Scholar 

  24. Beck CT, Gable RK. Ensuring content validity: an illustration of the process. J Nurs Meas. 2001;9(2):201–15.

    Article  CAS  PubMed  Google Scholar 

  25. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459–67.

    Article  Google Scholar 

  26. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.

    Article  CAS  PubMed  Google Scholar 

  27. Ding W, Song PXK. EM algorithm in Gaussian copula with missing data. Comput Stat Data Anal. 2016;101:1–11.

    Article  Google Scholar 

  28. Doka PJS, Danjin M, Dongs IS. HIV/AIDS-related stigma and discrimination among health-care providers in a tertiary health facility. J Med Sci. 2017;37(2):44.

    Article  Google Scholar 

  29. Hibbert M, Wolton A, Crenna-Jennings W, et al. Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK. AIDS Care. 2018;30(7):836–43.

    Article  CAS  PubMed  Google Scholar 

  30. Stringer KL, Turan B, McCormick L, et al. HIV-related stigma among healthcare providers in the deep south. AIDS Behav. 2016;20(1):115–25.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Magnus M, Herwehe J, Murtazarossini M, et al. Linking and retaining HIV patients in care: the importance of provider attitudes and behaviors. AIDS Patient Care STDS. 2013;27(5):297–303.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Stochl J, Jones PB, Croudace TJ. Mokken scale analysis of mental health and well-being questionnaire item responses: a non-parametric IRT method in empirical research for applied health researchers. BMC Med Res Methodol. 2012;12(1):1–16.

    Article  Google Scholar 

  33. Dean K, Walker Z, Jenkinson C. Data quality, floor and ceiling effects, and test–retest reliability of the mild cognitive impairment questionnaire. Patient Relat Outcome Meas. 2018;9:43–7.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank all the participants. We acknowledge the editors and the reviewers for insightful suggestions on this work.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yanhua Chen.

Ethics declarations

Conflict of interest

All the authors do not have any possible conflicts of interest.

Ethical Approval

Ethical approval was granted by the research ethics committee of the Affiliated Hospital of Southwest Medical University, in China.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xie, H., Yu, H., Watson, R. et al. Cross-Cultural Validation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS) in China. AIDS Behav 23, 1048–1056 (2019). https://doi.org/10.1007/s10461-018-2312-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-018-2312-1

Keywords

Navigation