Psychometric Properties of an Adapted Stigma Scale and Experiences of Stigma Associated with HIV Pre-exposure Prophylaxis Use Among Men Who have Sex with Men: A Mixed Methods Study

Gillespie, David; Williams, Andrew; Wood, Fiona; Couzens, Zoë; Jones, Adam; Richard, T. B.; Bruin, Marijn de; Hughes, Dyfrig; Hood, Kerenza

doi:10.1007/s10461-022-03967-0

Cited by 2 publications

(2 citation statements)

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“…Over the period during which this framework was developed, additional research has emerged. To ensure the current relevance of our model, we re‐ran our literature search in March 2023, finding seven articles which explored PrEP stigma among AGYW in African contexts [ 25 , 26 , 27 , 70 , 71 , 72 , 73 , 74 ] and seven that developed PrEP stigma scales [ 28 , 29 , 75 , 76 , 77 , 78 ]. Findings from these studies aligned with our model factors, confirming its contemporary relevance.…”

Section: Discussionmentioning

confidence: 99%

The development of a conceptual framework on PrEP stigma among adolescent girls and young women in sub‐Saharan Africa

Hartmann,

Nyblade,

Otticha

et al. 2024

J Int AIDS Soc.

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IntroductionStigma is a well‐known barrier to HIV testing and treatment and is an emerging barrier to pre‐exposure prophylaxis (PrEP) use. To guide future research, measurement and interventions, we developed a conceptual framework for PrEP stigma among adolescent girls and young women (AGYW) in sub‐Saharan Africa, a priority population for PrEP.MethodsA literature review, expert consultations and focus group discussions (FGDs) were conducted to adapt the Health Stigma and Discrimination Framework, describing the stigmatization process nested within the socio‐ecological framework. We reviewed all articles on PrEP stigma and on HIV, contraceptive or sexuality stigma among AGYW from 2009 to 2019. Expert consultations were conducted with 10 stigma or PrEP researchers and two Kenyan youth advisory boards to revise the framework. Finally, FGDs were conducted with AGYW PrEP users (4 FGDs; n = 20) and key influencers (14 FGDs; n = 72) in Kenya with the help of a Youth Research Team who aided in FGD conduct and results interpretation. Results from each phase were reviewed and the framework was updated to incorporate new and divergent findings. This was validated against an updated literature search from 2020 to 2023.ResultsThe conceptual framework identifies potential drivers, facilitators and manifestations of PrEP stigma, its outcomes and health impacts, and relevant intersecting stigmas. The main findings include: (1) PrEP stigma is driven by HIV, gender and sexuality stigmas, and low PrEP community awareness. (2) Stigma is facilitated by factors at multiple levels: policy (e.g. targeting of PrEP to high‐risk populations), health systems (e.g. youth‐friendly service availability), community (e.g. social capital) and individual (e.g. empowerment). (3) Similar to other stigmas, manifestations include labelling, violence and shame. (4) PrEP stigma results in decreased access to and acceptability of PrEP, limited social support and community resistance, which can impact mental health and decrease PrEP uptake and adherence. (5) Stigma may engender resilience by motivating AGYW to think of PrEP as an exercise in personal agency.ConclusionsOur PrEP stigma conceptual framework highlights potential intervention targets at multiple levels in the stigmatization process. Its adoption would enable researchers to develop standardized measures and compare stigma across timepoints and populations as well as design and evaluate interventions.

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Section: Discussionmentioning

confidence: 99%

The development of a conceptual framework on PrEP stigma among adolescent girls and young women in sub‐Saharan Africa

Hartmann,

Nyblade,

Otticha

et al. 2024

J Int AIDS Soc.

View full text Add to dashboard Cite

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“…One crucial element in achieving this goal is the availability of instruments to assess PrEP stigma. While a couple of instruments have been introduced [ 16 – 18 ], limiting factors hinder a holistic understanding of PrEP stigma on a global and multicultural level. First, the diverse use of different instruments across studies presents a challenge in synthesizing findings and comparing results (for an exemplary overview, see [ 12 ]).…”

Section: Introductionmentioning

confidence: 99%

The Pre-Exposure Prophylaxis Stigma Scale: Measurement Properties of an Adaptation in German and French

Ort,

Bardy

2024

Int J Public Health

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Objectives:This study aimed to adapt and validate the HIV PrEP Stigma Scale (HPSS) in French and German languages (HPSS-FR/DE) and assess its applicability across diverse linguistic and cultural contexts.Methods:The original scale was adapted to French and German and administered through an online survey in multiple European nations. A four-factor structure was extracted from the data, including negative social consequences, social pressure, self-support, and external support. The scale’s construct validity, reliability, and cross-linguistic consistency were evaluated.Results:The adapted HPSS-FR/DE demonstrated robust psychometric properties, good construct validity, acceptable reliability, and consistent measurement across different languages. This adaptation enhances its utility in multicultural settings, offering a comprehensive tool to assess PrEP-related stigma.Conclusion:This study provides a suitable tool to address PrEP stigma in multicultural environments to enhance PrEP uptake and adherence among men who have sex with men. Moreover, it lays the groundwork for further investigations into PrEP stigma across diverse populations and cultural settings, enabling the development of targeted public health interventions and policies to combat this issue effectively.

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Psychometric Properties of an Adapted Stigma Scale and Experiences of Stigma Associated with HIV Pre-exposure Prophylaxis Use Among Men Who have Sex with Men: A Mixed Methods Study

Cited by 2 publications

References 40 publications

The development of a conceptual framework on PrEP stigma among adolescent girls and young women in sub‐Saharan Africa

The development of a conceptual framework on PrEP stigma among adolescent girls and young women in sub‐Saharan Africa

The Pre-Exposure Prophylaxis Stigma Scale: Measurement Properties of an Adaptation in German and French

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