Validation of a modified Berger HIV stigma scale for use among patients with hepatitis C virus (HCV) infection

Saine, M. Elle; Moore, Tyler M.; Szymczak, Julia E.; Bamford, Laura; Barg, Frances K.; Mitra, Nandita; Schnittker, Jason; Holmes, John H.; Re, Vincent Lo

doi:10.1371/journal.pone.0228471

Cited by 20 publications

(22 citation statements)

References 80 publications

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“…In some studies, to assess the status of the perception of stigma among study participants, based on theoretical domains, including stereotypes, discrimination, shame, and social isolation, their status is assessed ( 19 ). Sometimes a questionnaire related to the perception of stigma related to another disease (such as the HIV Stigma Scale in our study) is used for this purpose ( 20 ). The questionnaire used in this study was a 22-item modified Stigma-related questionnaire for HIV patients ( 21 ).…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Associated Factors of Posttraumatic Stress Symptoms and Stigma among Health Care Workers in Contact with COVID-19 Patients

Zandifar¹,

Badrfam

Khonsari

et al. 2020

IJPS

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Objective: The global spread of COVID-19 has caused great psychological stress in health care workers (HCWs). This study aims to assess the prevalence and associated factors of posttraumatic stress symptoms (PTSS) and stigma among health care workers (HCWs) who are involved in treating COVID-19 patients. This study was conducted as part of studies related to assessing the mental health status of HCWs in Iran during the COVID-19 pandemic. Method: Overall, in this cross sectional study, 894 HCWs working in 9 general hospitals in Alborz province, Iran, in the field of diagnostic and treatment care of patients with COVID-19 were selected using multistage sampling method. PTSS and its subscales, including intrusion, avoidance, and hyper vigilance were obtained based on the Posttraumatic Stress Disorder-8 Item validated questionnaire. Information on Stigma's perception among HCWs was also obtained based on a questionnaire adopted from the HIV Stigma Scale. Predictors of PTSS and Stigma's perception among HCWs were assessed using multivariate logistic regression analysis. Results: Overall, 71.4% of the participants were women and 46.9% were front line staff. The prevalence of intrusion, avoidance, and hyper vigilance symptoms was 44.2% (95% CI: 40.8-47.6), 31. 8% (95% CI: 28.8-35.0), and 37.7% (95% CI: 34.5-41.0), respectively. A strong and positive significant correlation was found between stigma score with PTSD total score (coefficient: 0.83) and its components. In multivariate logistic regression model, female gender was associated with intrusion (OR: 1.46, 95% CI: 1.03-2.06) and avoidance (OR: 1.66, 95% CI: 1.147-2.417) and working in frontline increased the odds of intrusion (OR: 1.45, 95% CI: 1.06-1.97) and hyper vigilance (OR: 1.41, 95% CI: 1.03-1.91). Conclusion: The prevalence of PTSS is high among HCWs during COVID-19 pandemic and it is associated with some demographic characteristics of HCWs. This situation should be considered by health policymakers so that while trying to control the disease, the mental health status of this group of personnel should be given much attention.

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Section: Methodsmentioning

confidence: 99%

Prevalence and Associated Factors of Posttraumatic Stress Symptoms and Stigma among Health Care Workers in Contact with COVID-19 Patients

Zandifar¹,

Badrfam

Khonsari

et al. 2020

IJPS

View full text Add to dashboard Cite

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“…We conducted a cross‐sectional survey study among patients with a history of HCV infection who presented for care at outpatient infectious diseases clinics across Philadelphia between July 2018 and May 2019. The study setting and procedures have been previously described 30 …”

Section: Methodsmentioning

confidence: 99%

“…The primary study outcome was perception of HCV‐related stigma, measured by HCV Stigma Scale (HCV‐SS) Score 30 . The HCV‐SS is a validated 33‐item self‐administered questionnaire adapted from the Berger HIV Stigma Scale 42 .…”

Section: Methodsmentioning

confidence: 99%

“…The HCV‐SS is a validated 33‐item self‐administered questionnaire adapted from the Berger HIV Stigma Scale 42 . Previous psychometric evaluation of the HCV‐SS produced this unidimensional scale with sufficient reliability (Cronbach α = 0.96) and construct validity (85%) 30 . Item responses are recorded on a four‐point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree).…”

Section: Methodsmentioning

confidence: 99%

“…The factors associated with HCV‐related stigma remain unclear, primarily because, until only recently, no validated instruments existed to measure patient experiences of HCV‐related stigma 30 . To address this issue, we evaluated demographic, clinical and behavioural factors associated with HCV‐related stigma among patients with a history of HCV infection and determined whether experiences of HCV‐related stigma differed between HCV‐monoinfected and HIV/HCV‐coinfected patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determinants of stigma among patients with hepatitis C virus infection

Saine

Szymczak

Moore

et al. 2020

Journal of Viral Hepatitis

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Stigma around hepatitis C virus (HCV) infection is an important and understudied barrier to HCV treatment and elimination. The determinants of HCV-related stigma, including the impacts of stage of HCV treatment (ie spontaneously cleared; diagnosed, untreated; previously treated, not cured; currently being treated; and treated, cured) and coinfection with human immunodeficiency virus (HIV), remain unknown. To address these gaps, we conducted a cross-sectional study among patients with a history of HCV infection (n = 270) at outpatient clinics in Philadelphia from July 2018 to May 2019. We evaluated stigma using the validated HCV Stigma Scale, adapted from the Berger HIV Stigma Scale. Associations among HCV-related stigma and hypothesized demographic, behavioural, and clinical risk factors were evaluated by multivariable linear regression. Most participants (95.5%) experienced HCV-related stigma. Mean stigma scores did not differ significantly between HCV-monoinfected and HIV/HCVcoinfected participants (P = .574). However, we observed significant interactions between HIV status and multiple determinants; therefore, we stratified analyses by HIV status. Among HIV/HCV-coinfected participants, previous HCV treatment without cure, female gender, Hispanic/Latinx ethnicity and some college education were significantly associated with higher HCV-stigma scores. An annual income of $10 000-$40 000 was associated with significantly lower stigma scores. No significant associations were observed among HCV-monoinfected participants. We found that most participants experienced stigma associated with HCV diagnosis. While stigma scores were similar between HCV-monoinfected and HIV/HCV-coinfected participants, the determinants associated with HCV stigma differed by HIV status.

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Telling the story of intersectional stigma in HIV‐associated Kaposi's sarcoma in western Kenya: a convergent mixed‐methods approach

et al. 2022

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Introduction The experience of stigma can be multifaceted for people with HIV and cancer. Kaposi's sarcoma (KS), one of the most common HIV‐associated cancers in sub‐Saharan Africa, often presents with visible skin lesions that may put people at risk for stigmatization. In this way, HIV‐associated KS is unique, as people with KS can experience stigma associated with HIV, cancer, and skin disease simultaneously. The aim of this study is to characterize the intersectionality of HIV‐related, cancer‐related and skin disease‐related stigma in people living with HIV and KS. Methods We used a convergent mixed‐methods approach nested within a longitudinal study of people with HIV‐associated KS in western Kenya. Between February 2019 and December 2020, we collected quantitative surveys among all participants and conducted semi‐structured interviews among a purposive sample of participants. Quantitative surveys were adapted from the abridged Berger HIV Stigma Scale to assess overall stigma, HIV‐related stigma, cancer‐related stigma, and skin disease‐related stigma. Qualitative data were coded using stigma constructs from the Health Stigma and Discrimination Framework. Results In 88 semi‐structured interviews, stigma was a major barrier to KS diagnosis and treatment among people with HIV‐associated KS. Participant's stories of stigma were dominated by HIV‐related stigma, more than cancer‐related or skin disease‐related stigma. However, quantitative stigma scores among the 117 participants were similar for HIV‐related (Median: 28.00; IQR: 28.0, 34.0), cancer‐related (Median: 28.0; IQR: 28.0, 34.8), and skin disease‐related stigma (Median: 28.0; IQR: 27.0, 34.0). In semi‐structured interviews, cancer‐related and skin disease‐related stigma were more subtle contributors; cancer‐related stigma was linked to fatalism and skin‐related stigma was linked to visible disease. Participants reported resolution of skin lesions contributed to lessening stigma over time; there was a significant decline in quantitative scores of overall stigma in time since KS diagnosis (adjusted β = –0.15, p <0.001). Conclusions This study highlights the role mixed‐method approaches can play in better understanding stigma in people living with both HIV and cancer. While HIV‐related stigma may dominate perceptions of stigma among people with KS in Kenya, intersectional experiences of stigma may be subtle, and quantitative evaluation alone may be insufficient to understand intersectional stigma in certain contexts.

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Validation of a modified Berger HIV stigma scale for use among patients with hepatitis C virus (HCV) infection

Cited by 20 publications

References 80 publications

Prevalence and Associated Factors of Posttraumatic Stress Symptoms and Stigma among Health Care Workers in Contact with COVID-19 Patients

Prevalence and Associated Factors of Posttraumatic Stress Symptoms and Stigma among Health Care Workers in Contact with COVID-19 Patients

Determinants of stigma among patients with hepatitis C virus infection

Telling the story of intersectional stigma in HIV‐associated Kaposi's sarcoma in western Kenya: a convergent mixed‐methods approach

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