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

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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.

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References

  • Anderson, R. N., & Smith, B. L. (2005). Deaths: leading causes for 2002. National Vital Statistics Reports, 53(17), 67–70.

    Google Scholar 

  • Andrich, D. (1978). A rating scale formulation for ordered response categories. Psychometrika, 43, 561–573.

    Article  Google Scholar 

  • Bendel, R. B., & Afifi, A. A. (1977). Comparison of stopping rules in forward regression. Journal of the American Statistical Association, 72, 46–53.

    Article  Google Scholar 

  • Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring Stigma in People with HIV: Psychometric Assessment of the HIV Stigma Scale. Research in Nursing and Health, 24, 518–529.

    Article  PubMed  CAS  Google Scholar 

  • Black, B. P., & Miles, M. S. (2002). Calculating the risks and benefits of disclosure in African American women who have HIV. JOGNN–Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31(6), 688–697.

    Google Scholar 

  • Brooks, R. A., Etzel, M. A., Hinojos, E., Henry, C. L., & Perez, M. (2005). Preventing HIV among Latino and African American gay and bisexual men in a context of HIV-related stigma, discrimination, and homophobia: perspectives of providers. AIDS Patient Care and STDs, 19(11), 737–744.

    Article  PubMed  Google Scholar 

  • Brown, L., Macintyre, K., & Trujillo, L. (2003). Interventions to reduce HIV/AIDS stigma: What have we learned? AIDS Education and Prevention, 15(1), 49–69.

    Article  PubMed  Google Scholar 

  • CDC (Centre for Disease Control and Prevention). (2004). HIV/AIDS Surveillance Report: Cases of HIV infection and AIDS in the United States.

  • Clark, H. J., Lindner, G., Armistead, L., & Austin, B.-J. (2003). Stigma, disclosure, and psychological functioning among HIV-infected and non-infected African-American women. Women and Health, 38(4), 57–71.

    Article  Google Scholar 

  • Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765–776.

    Article  PubMed  CAS  Google Scholar 

  • Corrigan, P. W., River, L. P., Lundin, R., Wasowski, K., Campion, J., Mathisen, J., et al. (2000). Stigmatizing attributions about mental illness. Journal of Community Psychology, 28(1), 91–102.

    Article  Google Scholar 

  • Crandall, C. S. (1991). Multiple stigma and AIDS: Illness stigma and attitudes toward homosexuals and IV drug users in AIDS-related stigmatization. Journal of Community and Applied Social Psychology, (2), 165–172.

  • Crawford, A. M. (1996). Stigma associated with AIDS: A meta-analysis. Journal of Applied Social Psychology, 26(5), 398–416.

    Article  Google Scholar 

  • Emlet, C. (2005). Measuring Stigma in Older and Younger Adults with HIV/AIDS: An Analysis of an HIV Stigma Scale and Initial Exploration of Subscales. Research on Social Work Practice, 15(4), 291–300.

    Article  Google Scholar 

  • Fischer, A. R., & Shaw, C. M. (1999). African Americans’ mental health and perceptions of racist discrimination: The moderating effects of racial socialization experiences and self-esteem. Journal of Counseling Psychology, 46(3), 395–407.

    Article  Google Scholar 

  • Hambleton (2006). Good Practices for Identifying Differential Item Functioning. Medical Care, 44(11, Supplement 3), S182–S188.

  • Hambleton, S. H., & Rogers, H. (1991). Fundamentals of Item Response Theory. Newbury Park, CA: Sage Publications, Inc.

    Google Scholar 

  • Hawkins, T. (2006). Appearance-Related Side Effects of HIV-1 Treatment. AIDS Patient Care and STDs, 20(1), 6–18.

    Article  PubMed  Google Scholar 

  • Herek, G. M., Capitanio, J. P., & Widaman, K. F. (2002). HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999.[see comment]. American Journal of Public Health, 92(3), 371–377.

    Article  PubMed  Google Scholar 

  • Hudgens, S., Dineen, K., Webster, K., Lai, J -S., & Cella, D. (2004). Assessing Statistically and Clinically Meaningful Construct Deficiency/Saturation: Recommended Criteria for Content Coverage and Item Writing. Rasch Measurement Transactions, 17, 954–955.

    Google Scholar 

  • James, J., Carruthers, A., & Carruthers, J. (2002). HIV-Associated Facial Lipoatrophy. Dermatologic Surgery, 28, 979–986.

    Article  PubMed  Google Scholar 

  • Kalichman, S. (1998). Understanding AIDS. (2nd edn.). Washington, D.C.: American Psychological Association.

    Google Scholar 

  • Lee, R. S., Kochman, A., & Sikkema, K. J. (2002). Internalized stigma among people living with HIV-AIDS. AIDS and Behavior, 6(4), 309–319.

    Article  Google Scholar 

  • Lichtenstein, B., Laska, M. K., & Clair, J. M. (2002). Chronic sorrow in the HIV-positive patient: issues of race, gender, and social support. AIDS Patient Care and STDs, 16(1), 27–38.

    Article  PubMed  Google Scholar 

  • Linacre, J. M. (1994). Sample Size and Item Calibration Stability. Rasch Measurement Transactions, 7(4), 328.

    Google Scholar 

  • Linacre, J. M. (2005). A User’s Guide to WINSTEPS, MINISTEP, Rasch-Model Computer Programs. Chicago: John M. Linacre.

    Google Scholar 

  • Mehta, S., Moore, R. D., & Graham, N. M. (1997). Potential factors affecting adherence with HIV therapy. AIDS, 11(14), 1665–1670.

    Article  PubMed  CAS  Google Scholar 

  • Pedhazur, E. J. (1997). Multiple Regression in Behavioral Research. New York: Harcourt Brace College Publishers.

    Google Scholar 

  • Pryor, J. B., Reeder, G. D., Yeadon, C., & Hesson-McInnis, M. (2004). A dual-process model of reactions to perceived stigma. Journal of Personality and Social Psychology, 87(4), 436–452.

    Article  PubMed  Google Scholar 

  • Rao, D., Kekwaletswe, T. C., Hosek, S., Martinez, J., & Rodriguez, F. (2007). Stigma and Social Barriers to Medication Adherence with Urban Youth Living with HIV. AIDS Care, 19(1), 28–33.

    Article  PubMed  CAS  Google Scholar 

  • Reidpath, D. D., & Chan, K. (2005). A method for the quantitative analysis of the layering of HIV-related stigma. AIDS Care, 17(4), 425–432.

    Article  PubMed  CAS  Google Scholar 

  • Rintamaki, L. S., Davis, T. C., Skripkauskas, S., Bennett, C. L., & Wolf, M. S. (2006). Social stigma concerns and HIV medication adherence. AIDS Patient Care and STDs, 20(5), 359–368.

    Article  PubMed  Google Scholar 

  • Rusch, N., Angermeyer, M., & Corrigan, P. (2005). Mental illness stigma: Concepts, consequences, and initiative to reduce stigma. European Psychiatry, 20(8), 529–539.

    Article  PubMed  Google Scholar 

  • SPSS. (2002). SPSS for Windows, Rel. 11.5.1. Chicago: SPSS Inc.

    Google Scholar 

  • Teresi, J., Stewart, A., Morales, L., & Stahl, S. (2006). Measurement in a Multi-Ethnic Society. Medical Care, 44(11 Supplement 3), S3–S4.

    Article  PubMed  Google Scholar 

  • Thomas, B., Rehman, F., Suryanarayanan, D., Josephine, K., Dilip, M., Dorairaj, V., et al. (2005). How stigmatizing is Stigma in the life of people living with HIV: A study on HIV positive individuals from Chennai, South India. AIDS Care, 17(7), 795–801.

    PubMed  CAS  Google Scholar 

  • Tourangeau, R. (1984). Cognitive sciences and survey methods. In T. Jabine, M. Straf, J. Tanur & R. Tourageau (Eds.), Cognitive Aspects of Survey Methodology: Building a Bridge Between Disciplines (pp. 73–101). Washington, DC: National Academy Press.

    Google Scholar 

  • Treisman, G., & Angelino, A. (2004). The Psychiatry of AIDS. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Willis, G. B. (1999). Cognitive Interviewing: A “How To” Guide, From the short course “Reducing Survey Error through Research on the Cognitive and Decision Processes in Surveys”. Paper presented at the Meeting of the American Statistical Association.

  • Zumbo, B. (1999). A Handbook on the Theory and Methods of Differential Item Functioning (DIF): Logistic Regression Modeling as a Unitary Framework for Binary and Likert-Type (Ordinal) Item Scores. Ottawa, ON: Directorate of Human Resources Research and Evaluation, Department of National Defense.

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Acknowledgements

This study was supported in part by an Academy for Educational Development/Ford Foundation grant awarded to John Pryor and Bambi Gaddist. Deepa Rao is supported by a National Institute on Disability and Rehabilitation Research (NIDRR) Advanced Rehabilitation Research Training grant (H133P030002).

The authors would like to thank Elizabeth Hahn, M.A. and Randall Horton, Ph.D. for their helpful comments on earlier drafts of this article. The authors also thank Letitia Johnson-Arnold for her contributions in collecting the data from South Carolina participants. These results were also presented at the 16th International AIDS Conference in Toronto, Canada.

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Authors and Affiliations

  1. Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, 676 St. Clair, Suite 200, Chicago, IL, 60611, USA

    Deepa Rao

  2. Department of Psychology, Illinois State University, Normal, IL, USA

    John B. Pryor

  3. South Carolina HIV/AIDS Council, Columbia, SC, USA

    Bambi W. Gaddist

  4. Iowa Department of Public Health, Des Moines, IA, USA

    Randy Mayer

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  1. Deepa Rao
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  2. John B. Pryor
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  4. Randy Mayer
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Correspondence to Deepa Rao.

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Rao, D., Pryor, J.B., Gaddist, B.W. et al. Stigma, Secrecy, and Discrimination: Ethnic/Racial Differences in the Concerns of People Living with HIV/AIDS. AIDS Behav 12, 265–271 (2008). https://doi.org/10.1007/s10461-007-9268-x

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  • DOI: https://doi.org/10.1007/s10461-007-9268-x

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