Advertisement

Canadian Journal of Public Health

, Volume 108, Issue 4, pp 368–373 | Cite as

Preliminary investigation of the STBBI Stigma Scale: Description and pilot results

  • Anne C. Wagner
  • Rachel MacLean
Quantitative Research

Abstract

OBJECTIVES: Sexually transmitted and blood-borne infections (STBBIs) are associated with stigmatizing attitudes and beliefs, which can affect the quality of and access to health care, as well as mental health and quality of life. The current study describes the adaptation from an HIV-related stigma scale and pilot testing of a new STBBI Stigma Scale, assessing the stigmatizing attitudes and beliefs of health and social service providers in Canada.

METHODS: 144 health and social service providers from across Canada completed the newly adapted scale assessing stigma associated with HIV, hepatitis C, other viral STBBIs and bacterial STBBIs, as well as demographic information, a scale of social desirability and measures of convergent and divergent validity. Participants were recruited through listservs and completed the scale online.

RESULTS: The new scale, consisting of 21 items for each category, demonstrated excellent internal consistency, reliability, and convergent and divergent validity. The factor structure of the scale supports a tripartite model of stigma consisting of stereotyping, prejudice and discrimination. Stereotyping had the highest relative scores on the subscales, and attitudes regarding other viral STBBIs differed significantly from the other STBBI categories.

CONCLUSION: The new scale provides a contextually relevant and applicable psychometrically valid tool to assess STBBI-related stigma among health and social service providers in Canada. The tool can be used to assess attitudes and beliefs, as well as guide self-assessment and possible trainings for providers.

Key Words

Social stigma social discrimination reproductive health self-assessment surveys and questionnaires 

Mots Clés

stigmate social discrimination sociale santé reproductive auto-évaluation enquêtes et questionnaires 

Résumé

OBJECTIFS : Les infections transmissibles sexuellement et par le sang (ITSS) sont associées à des attitudes et des croyances stigmatisantes qui peuvent avoir un impact sur la qualité des soins de santé, l’accès aux soins, la santé mentale et la qualité de vie. L’étude en cours décrit l’adaptation d’une échelle de stigmatisation liée au VIH et l’essai pilote d’une nouvelle Échelle de stigmatisation des ITSS qui évalue les attitudes et les croyances stigmatisantes des dispensateurs de services sociaux et de santé au Canada.

MÉTHODE : 144 dispensateurs de services sociaux et de santé du Canada ont rempli l’échelle nouvellement adaptée évaluant la stigmatisation associée au VIH, à l’hépatite C, aux autres ITSS virales, aux ITSS bactériennes; les données démographiques, une échelle de désirabilité sociale et des indicateurs de validité convergente et divergente ont aussi été testés. Les participants ont été recrutés à l’aide de gestionnaires de listes de diffusion et ont rempli l’échelle en ligne.

RÉSULTATS : La nouvelle échelle, qui comprend 21 éléments dans chaque catégorie, a affiché d’excellents résultats sur les plans de la cohérence interne, de la fiabilité, ainsi que de la validité convergente et divergente. La structure factorielle de l’échelle appuie un modèle de stigmatisation en trois parties: stéréotypes, préjugés et discrimination. Les stéréotypes ont eu les résultats relatifs les plus élevés des trois sous-échelles, et les attitudes à l’égard des autres ITSS virales ont présenté des écarts significatifs par rapport aux autres catégories d’ITSS.

CONCLUSION : La nouvelle échelle offre un outil psychométriquement valide à la fois contextuellement approprié et applicable pour évaluer la stigmatisation liée aux ITSS chez les dispensateurs de services sociaux et de santé du Canada. Cet outil peut servir à évaluer les attitudes et les croyances, ainsi qu’à guider une auto-évaluation et d’éventuelles formations pour les dispensateurs.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Joint United Nations Programme on HIV/AIDS (UNAIDS). UNAIDS Terminology Guidelines. Geneva, Switzerland: Joint United Nations Program on HIV/AIDS, 2015.Google Scholar
  2. 2.
    Balfe M, Brugha R, O’Donovan D, O’Connell E, Vaughn D. Young women’s decisions to accept chlamydia screening: Influences of stigma and doctorpatient interactions. BMC Public Health 2010;10:425. PMID: 20642845. doi: 10. 1186/1471-2458-10-425.Google Scholar
  3. 3.
    Fortenberry JD, McFarlane M, Bleakley A, Bull S, Fishbein M, Grimley DM, et al. Relationships of stigma and shame to gonorrhea and HIV screening. Am J Public Health 2002;92(3):378–81. PMID: 11867314. doi: 10.2105/AJPH. 92.3.378.CrossRefGoogle Scholar
  4. 4.
    Mahajan AP, Sayles JN, Patel VA, Remien RH, Ortiz D, Szekeres G, et al. Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS 2008;22(Suppl 2):S67–79. PMID: 18641472. doi: 10. 1097/01.aids.0000327438.13291.62.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Mill J, Edwards N, Jackson R, Austin W, MacLean L, Reintjes F. Accessing health services while living with HIV: Intersections of stigma. Can J Nurs Res 2009;41(3):168–85. PMID: 19831060.PubMedGoogle Scholar
  6. 6.
    Rusch ML, Shoveller JA, Burgess S, Stancer K, Patrick DM, Tyndall, MW. Preliminary development of a scale to measure stigma relating to sexually transmitted infections among women in a high risk neighbourhood. BMC Womens Health 2008;8:21. PMID: 19021915. doi: 10.1186/1472-6874-8-21.CrossRefGoogle Scholar
  7. 7.
    Kinsler JJ, Wong MD, Sayles JN, Davis C, Cunningham, WE. The effect of perceived stigma from a health care provider on access to care among a low-income HIV-positive population. AIDS Patient Care STDs 2007;21(8): 584–92. PMID: 17711383. doi: 10.1089/apc.2006.0202.CrossRefGoogle Scholar
  8. 8.
    Earnshaw VA, Chaudoir, SR. From conceptualizing to measuring HIV stigma: A review of HIV stigma mechanism measures. AIDS Behav 2009;13:1160–77. PMID: 19636699. doi: 10.1007/s10461-009-9593-3.CrossRefGoogle Scholar
  9. 9.
    Wagner AC, Hart TA, McShane KE, Margolese S, Girard, TA. Health care provider attitudes and beliefs about people living with HIV: Initial validation of the health care provider HIV/AIDS stigma scale (HPASS). AIDS Behav 2014; 18(12):2397–408. PMID: 24965675. doi: 10.1007/s10461-014-0834-8.CrossRefGoogle Scholar
  10. 10.
    Gagnon M. Re-thinking HIV-related stigma in health care settings: A qualitative study. J Assoc Nurses AIDS Care 2015;26(6):703–719. PMID: 26300466. doi: 10.1016/j.jana.2015.07.005.CrossRefGoogle Scholar
  11. 11.
    Windsor LC, Benoit E, Ream GL, Forenza B. The provider perception inventory: Psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior. AIDS Care 2013;25(5):586–91. PMID: 23082899. doi: 10.1080/09540121.2012.726338.CrossRefGoogle Scholar
  12. 12.
    Rutledge SE, Whyte J, Abell N, Brown KM, Cesnales, NI. Measuring stigma among health care and social service providers: The HIV/AIDS provider stigma inventory. AIDS Patient Care STDs 2011;25(11):673–82. PMID: 21967495. doi: 10.1089/apc.2011.0008.CrossRefGoogle Scholar
  13. 13.
    Feyissa GT, Abebe L, Girma E, Woldie M. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia. BMC Public Health 2012;12:522. PMID: 22794201. doi: 10.1186/1471-2458-12-522.Google Scholar
  14. 14.
    Neal TM, Lichtenstein B, Brodsky, SL. Clinical implications of stigma in HIV/AIDS and other sexually transmitted infections. Int J STD AIDS 2010; 21(3):158-60. PMID: 20215618. doi: 10.1258/ijsa.2008.008445.Google Scholar
  15. 15.
    Public Health Agency of Canada. What is an Integrated, Holistic Approach to Sexually Transmitted and Blood Borne Infections. Ottawa, ON: PHAC, 2014. Available at: http://pacificaidsnetwork.org/wp-content/uploads/2014/10/integration-webinar-5Nov2014_Final.pdf (Accessed January 12, 2016).Google Scholar
  16. 16.
    Brown T. Confirmatory Factor Analysis. New York, NY: Guilford, 2006.Google Scholar
  17. 17.
    Froman RD, Owen, SV. Further validation of the AIDS attitude scale. Res Nurs Health 1997;20(2):161–7. PMID: 9100746. doi: 10.1002/(SICI)1098-240X (199704)20:2<161::AID-NUR8>3.0.CO;2-I.CrossRefGoogle Scholar
  18. 18.
    Fischer DG, Fick C. Measuring social desirability: Short forms of the Marlowe-Crowne social desirability scale. Educ Psychol Meas 1993;53:417–24. doi: 10.1177/0013164493053002011.CrossRefGoogle Scholar
  19. 19.
    IBM Corp. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp, 2016.Google Scholar

Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  1. 1.Department of PsychologyRyerson UniversityTorontoCanada
  2. 2.Canadian Public Health AssociationOttawaCanada

Personalised recommendations