Stigma, Secrecy, and Discrimination: Ethnic/Racial Differences in the Concerns of People Living with HIV/AIDS

Abstract

The HIV Stigma Scale is a measure that assesses stigmatization perceived and experienced by people living with HIV/AIDS (PLWHA). Using Item Response Theory (IRT) methodologies, the present study examined HIV Stigma Scale responses from 224 Black and 317 White PLWHA to determine whether cross-cultural differences exist in responses to items of the scale. IRT analysis revealed that eleven out of forty items functioned differently across groups. Black respondents had a higher probability of indicating greater stigmatization on items that described situations in which others discriminated against them, and White respondents had a higher probability of indicating greater stigmatization on items that described a resolve to keep their status a secret and fears of interpersonal rejection. These differences suggest that PLWHA have different experiences of stigma based on their ethnic/racial background, either because of cultural differences or the ways in which the participants interpreted items of the HIV Stigma Scale.

Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a Sample of HIV-positive Adults

“…The instrument (and various short forms) has been found to have good internal consistency reliability in African Americans (Rao et al, 2007;Wright et al, 2007) and a rural population of predominantly white men living in New England (Bunn et al, 2007). However, the development of the instrument did not include direct input from HIV-positive women and men, such as interviews or focus groups to inform item content or formal cognitive interviewing.…”

“…However, the development of the instrument did not include direct input from HIV-positive women and men, such as interviews or focus groups to inform item content or formal cognitive interviewing. Additionally, in both confirmatory and exploratory factor analysis the measure has been shown to lack item discrimination across scales with many items loading onto multiple scales (Berger et al, 2001;Rao et al, 2007). A measure capturing the multifaceted nature of stigma for a diverse population of PLHA can add to our understanding of the relationship between stigma and health outcomes, and assist in evaluating the effectiveness of interventions to mitigate the negative effects of stigma for PLHA.…”

The Effects of HIV Stigma on Health, Disclosure of HIV Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV

“…The amount of stigma experienced by some PLWHA may also differ because negative attitudes about PLWHA may be more or less prevalent in their communities and social networks (Centers for Disease Control Prevention 2000; Rao et al 2008;Swendeman et al 2006). Highly educated persons tend to have less stigmatizing beliefs about PLWHA (Bos et al 2001;Centers for Disease Control Prevention 2000).…”

Deficits in Self-Awareness Impact the Diagnosis of Asymptomatic Neurocognitive Impairment in HIV

“…Social isolation is common in the older HIV population, and may limit an individual's understanding of peer performance. [29][30][31][32] Thus, overestimations and underestimations may reflect a lack of insight into, or awareness of, the abilities of others, rather than a lack of personal insight. There is also the possibility that a subject might be unfamiliar with the task approximated by the FP test, for instance the subject may not drive or be responsible for paying bills, and this may make it difficult to provide an accurate pretest self-assessment.…”