Measuring Stigma Among Health Care and Social Service Providers: The HIV/AIDS Provider Stigma Inventory

Abstract

Initial validation of the HIV/AIDS Provider Stigma Inventory (HAPSI), piloted on a sample of 174 nursing students, supported the psychometric qualities of a suite of measures capturing tendencies to stigmatize and discriminate against people living with HIV/AIDS (PLHA). Derived from social psychology and mindfulness theories, separate scales addressing awareness, acceptance, and action were designed to include notions of labeling, stereotyping, outgrouping, and discriminating. These were enhanced to capture differences associated with personal characteristics of PLHA that trigger secondary stigma (e.g., sexual orientation, injection drug use, multiple sex partners) and fears regarding instrumental and symbolic stigma. Reliabilities were strong (coefficients α for 16 of 19 resulting measures ranged from 0.80 to 0.98) and confirmatory factor analyses indicated good model fit for two multidimensional (Awareness and Acceptance) and one unidimensional (Action) measure. Evidence of convergent construct validity supported accuracy of primary constructs. Implications for training and professional socialization in health care are discussed.

Pharmacy Student Attitudes and Willingness to Engage in Care with People Living with HIV/AIDS

“…1,12,13 These scales were revised to adjust for language and phrasing to be less restrictive to AIDS and consider more broadly HIV, maximize student understanding of questions, limit social desirability bias, and attempt to elicit more subtle stigmatizing attitudes. For example, previously validated scales from the 1980s used "AIDS" and were developed prior to effective antiretroviral therapy.…”

“…10 Shifts in attitudes and knowledge among health professions students toward PLWHA may have occurred as a result of improvements in antiretroviral therapy and how such therapy has led to substantial reductions in morbidity, mortality, and transmission of HIV infection. 9,10,12,13 However, to explore these shifts more closely, there is need to ensure measures are consistent with current language (ie, removing language specifying only AIDS and including persons living with HIV) and avoid as much as possible social desirability bias (ie, tendency to respond in a more favorable way to researchers). Further, to examine attitudinal and behavioral shifts, it is important to develop theoretical models for how factors contribute to the formation of the attitudes and behaviors.…”

The Impact of Anticipated HIV Stigma on Delays in HIV Testing Behaviors: Findings from a Community-Based Sample of Men Who Have Sex with Men and Transgender Women in New York City

“…This fear is not surprising, as there are real social consequences of acquiring HIV, such as rejection by, and isolation and discrimination from significant others and providers. 37,55 Fear-based public health campaigns have produced mixed results, whereby some individuals may internalize stigmatizing messages and engage in avoidance coping strategies to alleviate those feelings. Our study did not assess individuals' stereotypes and prejudice about persons living with HIV.…”

“…34 Similarly, studies have illustrated that people at risk for HIV or living with the disease may delay or fail to access care, to avoid rejection by providers, families, and the general public. [35][36][37] However, little research has examined the impact on HIVtesting of anticipated HIV stigma, that is, HIV-negative individuals' expectations that they would experience HIV stigma themselves if they were infected. In the case of anticipated stigma, HIV-negative individuals may or may not endorse stigmatizing beliefs or stereotypes about HIV-positive persons themselves.…”

Preliminary investigation of the STBBI Stigma Scale: Description and pilot results

“…As much of the research in the field has focused on measuring HIV stigma, it was further decided that the HPASS tool should be adapted to incorporate a broader range of STBBIs, including HIV, hepatitis C, other viral STIs and bacterial STIs. [9][10][11][12][13] These four distinct categories of STBBI were selected on the basis of route of transmission and treatment regimen, and were used to explore whether societal attitudes and beliefs differed for the various STBBIs, as has been suggested by other studies. 14 Further, by incorporating a broader range of STBBIs, the STBBI Stigma Scale better reflects the continual shift towards a more integrated approach to STBBIs in Canada and internationally.…”