Measurement of Stigma in Men Who Have Sex with Men in Hanoi, Vietnam: Assessment of a Homosexuality-Related Stigma Scale

Abstract

Objective. To develop and assess a homosexuality-related stigma scale among men who have sex with men (MSM) in Hanoi, Vietnam. Methods. We conducted a cross-sectional study using respondent-driven sampling in Hanoi, Vietnam, in 2011. We used a cross-validation approach. Factor analysis was performed, and interitem correlation matrices were constructed to identify the latent factor structures, examine the goodness of fit, and assess convergent and discriminant validity of the determined scales. Internal consistency checks were performed in split samples and whole sample, and separately for each determined factor. Results. The findings were consistent in split samples. Three homosexuality-related stigma factors were identified: enacted homosexual stigma, perceived homosexual stigma, and internalized homosexual stigma. The fit indices of the confirmatory factor analysis in both split samples supported the hypothesized three-factor structures (in subsamples A and B: χ 2/degrees of freedom ratio = 1.77 and 1.59, nonnormed fit index = 0.92 and 0.94, comparative fit index = 0.93 and 0.95, and the root mean square of approximation = 0.06 and 0.05, resp.). The interitem correlation supported the convergent and discriminant validity of the scales. The reliability of the three scales indicated good consistency (Cronbach's alpha: 0.79–0.84) across split samples and for the whole data. Conclusion. Our scales have good psychometric properties for measuring homosexuality-related stigma. These comprehensive and practical tools are crucial not only to assess stigma against MSM and its consequence, but also to guide the development of interventions targeting MSM, as well as to evaluate the efficacy of existing stigma reduction efforts in Vietnam and other countries with similar settings.

Transactional sex among men who have sex with men participating in the CohMSM prospective cohort study in West Africa

“…Finally, our study showed that those who had experienced stigmatization were significantly more likely to practice TS. To measure stigmatization, we decided to use the Homosexuality-Related Stigma Scale, developed and validated in Vietnam [38]. This scale takes into account all three types of MSM stigmatization (experienced, perceived and internalized).…”

“…c) Homosexuality-related stigmatization during the previous 6 months : we constructed the following three scales for homosexuality-related stigmatization, each scale ranging from 0 to 10, based on items from a previous study (S2 Appendix) [38]: “experienced homosexual stigmatization” (based on 5 items, Cronbach’s alpha = 0.83); “perceived homosexual stigmatization” (based on 11 items, Cronbach’s alpha = 0.54); and “internalized homosexual stigmatization” (based on 8 items, Cronbach’s alpha = 0.73).…”

Transactional sex among men who have sex with men participating in the CohMSM prospective cohort study in West Africa

“…Finally, our study - which is the first to explore the different types of stigmatization (especially internalized) in MSM in West Africa – showed that MSM-TS were significantly more likely to have experienced stigmatization. To measure stigmatization, we decided to use the Homosexuality-Related Stigma Scale, developed and validated in Vietnam [33]. This scale takes into account all three types of MSM stigmatization (experienced, perceived and internalized).…”

“…c) Stigmatization during the previous 6 months: the following three sub-scores, ranging from 0 to 10, were constructed, based on items from a previous study (S2 appendix) [33]: “experienced stigmatization during the previous 6 months” (based on 5 items, Cronbach’s alpha=0.83); “perceived stigmatization” (based on 11 items, Cronbach’s alpha=0.54); and “internalized stigmatization” (based on 8 items, Cronbach’s alpha=0.73).…”

Male clients of male sex workers in West Africa: A neglected high-risk population

“…c) Stigmatization during the previous 6 months: three sub-scores were constructed ranging from 0 to 10. They were based on items taken from previous study (S3 Appendix) [37]: 1) “experienced stigmatization” (based on 5 items, Cronbach’s alpha = 0.58); 2) “perceived stigmatization” (based on 11 items, Cronbach’s alpha = 0.70); and 3) “internalized stigmatization” (based on 8 items, Cronbach’s alpha = 0.80).…”