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

McAteer, Carole I.; Truong, Nhan-Ai Thi; Aluoch, Josephine; Deathe, Andrew R.; Nyandiko, Winstone; Marete, Irene; Vreeman, Rachel C.

doi:10.7448/ias.19.1.21204

Cited by 30 publications

(28 citation statements)

References 42 publications

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“…However, to our knowledge, this study includes the widest range of stigma types within existing quantitative studies on adolescent HIV in sub‐Saharan Africa. Second, following standard practice [42,48], all of our discrimination variables were measured by adolescent self‐report. Therefore, it could be argued that these are measures of perceived rather than actual discrimination.…”

Section: Discussionmentioning

confidence: 99%

Multiple forms of discrimination and internalized stigma compromise retention in HIV care among adolescents: findings from a South African cohort

et al. 2020

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Introduction Efficacious antiretroviral treatment (ART) enables people to live long and healthy lives with HIV but young people are dying from AIDS‐related causes more than ever before. Qualitative evidence suggest that various forms of HIV‐related discrimination and resulting shame act as profound barriers to young people’s engagement with HIV services. However, the impact of these risks on adolescent retention in HIV care has not been quantified. This study has two aims: (1) to examine whether and how different types of discrimination compromise retention in care among adolescents living with HIV in South Africa; and (2) to test whether internalized stigma mediates these relationships. Methods Between 2014 and 2017, adolescents living with HIV (aged 10 to 19) from 53 health facilities in the Eastern Cape, South Africa, were interviewed at baseline (n = 1059) and 18‐month follow‐up (n = 979, 92.4%), with responses linked to medical records. Data were analysed through multiple regression and mediation models. Results About 37.9% of adolescents reported full retention in care over the 2‐year period, which was associated with reduced odds of viral failure (OR: 0.371; 95% CI: .224, .614). At baseline, 6.9% of adolescents reported discrimination due to their HIV status; 14.9% reported discrimination due to HIV in their families and 19.1% reported discrimination in healthcare settings. Healthcare discrimination was associated with reduced retention in care both directly (effect: −0.120; CI: −0.190, −0.049) and indirectly through heightened internalized stigma (effect: 0.329; 95% CI: 0.129, 0.531). Discrimination due to family HIV was associated with reduced retention in care both directly (effect: −0.074, CI: −0.146, −0.002) and indirectly through heightened internalized stigma (effect: 0.816, CI: 0.494, 1.140). Discrimination due to adolescent HIV was associated with reduced retention in care only indirectly, through increased internalized stigma (effect: 0.408; CI: 0.102, 0.715). Conclusions Less than half of adolescents reported 2‐year retention in HIV care. Multiple forms of discrimination and the resultant internalized stigma contributed to this problem. More intervention research is urgently needed to design and test adolescent‐centred interventions so that young people living with HIV can live long and healthy lives in the era of efficacious anti‐retroviral treatment.

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Section: Discussionmentioning

confidence: 99%

Multiple forms of discrimination and internalized stigma compromise retention in HIV care among adolescents: findings from a South African cohort

et al. 2020

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“…Past systematic reviews have summarised the effectiveness of specific types of HIV prevention interventions. Examples include reviews of programmes that reduce stigma,20 that synthesise factors associated with programme success such as adherence,21 and that catalogue common measures for indicators such as stigma,22 condom use23 or HIV clinical care 24. Two other reviews have looked at the effectiveness of community empowerment programmes on HIV prevention with marginalised populations 6 25.…”

Section: Introductionmentioning

confidence: 99%

Do combination HIV prevention programmes result in increased empowerment, inclusion and agency to demand equal rights for marginalised populations in low-income and middle-income countries? A systematic review

Brody,

Sok,

Tuot

et al. 2019

BMJ Glob Health

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IntroductionThis systematic review aims to determine if combination HIV prevention programmes include outcome measures for empowerment, inclusion and agency to demand equal rights and measure the relationship between empowerment and HIV prevention outcomes.MethodsAn electronic literature search of PubMed, POPLINE, Index Medicus and Google Scholar was conducted between August and October 2018. We included studies that evaluated combination prevention programmes that had all three types of intervention components and that specifically serve members of populations disproportionately affected by HIV published from 2008 to 2018. The selected studies were screened for inclusion, and relevant data abstracted, assessed for bias and synthesised.ResultsThis review included a total of 15 studies. Findings indicate that combination HIV prevention programmes for marginalised populations have delivered a variety of theory-based behavioural and structural interventions that support improvements in empowerment, inclusion and agency. However, empowerment, inclusion and least of all agency are not measured consistently or in a standardised way. In addition, analysis of their relationships with HIV prevention outcomes is rare. Out of our 15 included studies, only two measured a relationship between an empowerment, inclusion or agency outcome and an HIV prevention outcome.ConclusionThese findings suggest that policy-makers, programme planners and researchers might need to consider the intermediate steps on the pathway to increased condom use and HIV testing so as to explain the ‘how’ of their achievements and inform future investments in HIV prevention. This will support replication and expansion of programmes and ensure sustainability of the programmes.PROSPERO registration numberCRD42018106909

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“…Various paradigms, approaches and techniques have been attempted to define, conceptualize, measure and provide solutions to HIV-related stigma, and has also yielded valuable results [9][10][11][12][13][14][15][16], including the design and development of a great number of scales and accompanying questions to measure and compare different dimensions of stigma in a variety of cultural contexts and with the three most commonly-mentioned groups (i..e, healthcare workers, HIV-infected individuals and the general population). However, the lack of a standardized instrument makes it difficult to measure stigma consistently and thus poses a challenge to compare and contrast evaluated interventions [4,17,18].…”

Section: Introductionmentioning

confidence: 99%

“…However, the lack of a standardized instrument makes it difficult to measure stigma consistently and thus poses a challenge to compare and contrast evaluated interventions [4,17,18]. Furthermore, although scales were adapted to different linguistic and sociocultural contexts, their reliability and validity were rarely tested [12]. Therefore, there is a need for developing a standardized, reliable and valid measurement tool to assess the current level and predictors of HIV-related stigma, and subsequently develop, implement and evaluate anti-stigma interventions.…”

Section: Introductionmentioning

confidence: 99%

Application of the Chinese version of Zelaya's HIV-related stigma scale to undergraduates in mainland China

Ruan

Zhou

et al. 2019

Preprint

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Background: This cross-sectional study aims to validate the Chinese version of Zelaya's HIV-related Stigma Scale (CVZHSS) among a large undergraduate sample in mainland China, and apply it to measure the level of different dimensions of stigma and their respective determinants.Methods From September 10, 2018, to January 9, 2019, a total of 10665 eligible undergraduates conveniently drawn from 30 provinces in mainland China (except for Tibet) completed the self-designed online questionnaire distributed via sojump.com voluntarily, anonymously and confidentially. Both exploratory and confirmatory factor analyses (EFA and CFA) were first performed to test its construct validity, Cronbach's alpha was then used to assess its internal consistency, and Logistic regression analyses were finally carried out to identify predictors of various dimensions of stigma. Results As expected from the original model, four factors (i.e., "fear of casual transmission", "moral judgment", "personal stigma" and "perceived community stigma") were extracted using principal component analysis with varimax rotation, accounting for 63.26% of the total variance. The CFA further confirmed the four-factor construct (CFI=0.92, GFI=0.91, RMSEA=0.07). In addition, all the four factors demonstrated acceptable internal consistency with Cronbach's alpha ranging from 0.83 to 0.92. Stigma as measured by "fear of casual transmission" (74.4%), "moral judgement" (61.6%), "personal stigma" (79.0%) and "perceived community stigma"(36.5%) is highly prevalent among undergraduates. Except for non-freshmen, less knowledge about HIV and unsafe sex which were consistently associated with higher levels of stigma in all four dimensions, other eight variables including gender, residential area, major, sexual orientation, having ever being tested perception of HIV risk, willingness to utilize HTC service and awareness of the national AIDS policy played differential roles in affecting different dimensions of stigma. Conclusions The CVZHSS is a reliable and valid measurement tool and can be used to identify undergraduates with high levels of stigma. However, the four dimensions (Fear, moral judgement, personal stigma and perceived community stigma) were respectively influenced by different determinants, and thus should be treated independently when designing, implementing and evaluating stigma reduction programs.

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

Cited by 30 publications

References 42 publications

Multiple forms of discrimination and internalized stigma compromise retention in HIV care among adolescents: findings from a South African cohort

Multiple forms of discrimination and internalized stigma compromise retention in HIV care among adolescents: findings from a South African cohort

Do combination HIV prevention programmes result in increased empowerment, inclusion and agency to demand equal rights for marginalised populations in low-income and middle-income countries? A systematic review

Application of the Chinese version of Zelaya's HIV-related stigma scale to undergraduates in mainland China

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