Verifying Quantitative Stigma and Medication Adherence Scales Using Qualitative Methods among Thai Youth Living with HIV/AIDS

Abstract

HIV/AIDS-related stigma has been linked to poor adherence resulting in drug resistance and the failure to control HIV. This study used both quantitative and qualitative methods to examine stigma and its relationship to adherence in 30 HIV-infected Thai youth aged 14 to 21 years. Stigma was measured using the HIV stigma scale and its 4 subscales, and adherence was measured using a visual analog scale. Stigma and adherence were also examined by in-depth interviews. The interviews were to determine whether verbal responses would match the scale's results. The mean score of stigma perception from the overall scale and its 4 subscales ranged from 2.14 to 2.45 on a scale of 1 to 4, indicating moderate levels of stigma. The mean adherence score was .74. The stigma scale and its subscales did not correlate with the adherence. Totally, 17 of the respondents were interviewed. Contrary to the quantitative results, the interviewees reported that the stigma led to poor adherence because the fear of disclosure often caused them to miss medication doses. The differences between the quantitative and the qualitative results highlight the importance of validating psychometric scales when they are translated and used in other cultures.

A systematic review of measures of HIV/AIDS stigma in paediatric HIV‐infected and HIV‐affected populations

“…Of the 22 final articles, eight studies were conducted in the United States [9,16,19–24], five in Africa [10,15,25–27], eight in Asia [28–35] and one in Sweden [36]. Seven unique studies had large sample sizes ( N >900): four studies with the same orphaned, vulnerable children and comparison children were conducted in China [31–34], and three were conducted in Africa [10,15,25].…”

“…Seven unique studies had large sample sizes ( N >900): four studies with the same orphaned, vulnerable children and comparison children were conducted in China [31–34], and three were conducted in Africa [10,15,25]. Five of the studies focused on HIV-affected children [10,25,27,31,37], nine focused on HIV-infected children [16,19,21,23,24,26,28,29,36] and eight focused on comparing groups of HIV/AIDS orphans, orphans from other illnesses and vulnerable children [9,20,22,30,32–35]. …”

“…Nine of the studies focused on implementing or validating a stigma scale with HIV-infected paediatric or young adult participants [16,19,21,23,24,26,28,29,36]. Four of these studies focused on special populations: two recruited only participants who were young men who have sex with men (MSM) [19,24], one recruited only behaviourally infected female participants [26] and one recruited only substance-using young people [23].…”

“…Four of these studies focused on special populations: two recruited only participants who were young men who have sex with men (MSM) [19,24], one recruited only behaviourally infected female participants [26] and one recruited only substance-using young people [23]. The five remaining studies, all of which were smaller studies ( N <900), included general populations of HIV-infected youth [16,21,28,29,36]. …”

“…[29] and Fongkaew et al . [28] used translated versions of the full HSS to assess stigma in Thai youth living with HIV. Rongkavilit et al .…”