Introduction Tuberculosis (TB) remains a highly stigmatised disease that can cause or exacerbate mental health disorders. Despite increased awareness of the importance of reducing TB stigma, validated tools to measure TB stigma remain scarce. This study aimed to culturally adapt and validate the Van Rie TB Stigma Scale in Indonesia, a country with the second largest TB incidence worldwide. Methods We validated the scale in three phases: translation, cultural adaptation, and psychometric evaluation. We invited diverse experts to an interdisciplinary panel for the cross-cultural adaptation, then performed a psychometric evaluation of the scale: exploratory and confirmatory factor analyses, reliability analysis, and correlation analysis with Patient Health Questionnaire 9 [PHQ-9]. Results We culturally adapted the original scale's language and content during the translation and cultural adaptation phases. After psychometric evaluation with 401 participants in seven provinces of Indonesia, we removed two items. The new scale had two forms: (A) patient and (B) community perspective forms. Both forms had good internal consistency, with respective Cronbach's alpha values of 0.738 and 0.807. We identified three loading factors in Form A (disclosure, isolation, and guilty) and two loading factors in Form B (isolation and distancing). The scale showed correlation with PHQ-9 (Form A, rs = 0.347, p < 0.001; Form B, rs = 0). Conclusions The culturally adapted Indonesian version of Van Rie's TB Stigma Scale is comprehensive, reliable, internally consistent, and valid. The scale is now ready for applied scale-up in research and practice to measure TB-stigma and evaluate the impact of TB-stigma reduction interventions in Indonesia.

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Human immunodeficiency virus (HIV) has continuously been considered a scourge in Indonesia. Negative societal stance might be attributed to the poor biological, psychological, and emotional knowledge of HIV. Here we aimed to demonstrate the level of knowledge, stigma, and barriers for accessing HIV services. We conducted a cross-sectional survey in December 2019 in Kemayoran District, Jakarta, Indonesia. The survey consisted of a demographic section, HIV-Knowledge Questionnaire 18, and Stigma Questionnaires. An in-depth interview was conducted with eight subjects representing high-risk HIV and healthcare professionals; in-vivo and thematic analysis were employed. Overall, 83 respondents participated, 50.6% male, and 61.7% aged 26-45 years old. Instrumental, symbolic, and civility stigma were significantly higher in 25.9%, 19.8%, and 17.3% of samples, respectively. Stigma was associated with HIV knowledge (λ: 0.887, df: 3, partial η2: 0.113), and high knowledge level decreased the odds of instrumental stigma (OR: 0.292, 95% CI 0.095-0.900, p<0.05). Fear of discrimination and limited information was identified as intrinsic factors, while media portrays HIV and extraneous screening hours as extrinsic factors. The knowledge on HIV is still low at the community level in the Indonesian capital, which correlates to higher stigma and inhibits the high-risk population from accessing HIV medical services.

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