Validation and Abbreviation of an HIV Stigma Scale in an Adult Spanish-Speaking Population in Urban Peru

Abstract

The purpose of this study was to validate the Spanish version of the Berger HIV Stigma Scale in an urban Spanish-speaking population in Peru and create a valid and reliable abridged version of the scale. Participants were HIV-infected adults enrolled in an observational study to examine the effectiveness of a community-based antiretroviral therapy adherence intervention. Approximately half of participants were female, and the median age at enrollment was 30.5 years. The Spanish version of the full HIV Stigma Scale was internally reliable, demonstrated good construct validity, and was sensitive to change over time. The full HIV Stigma Scale was abbreviated by removing items that impaired subscale internal reliability, did not correlate with other subscale items, or demonstrated low factor correlations. The resulting abridged scale contained 21 of the 40 original items and revealed properties similar to the full Spanish version.

Appendix

Spanish translation of the HIV Stigma Scale

Item	Englisha	Spanish Translationb
1	In many areas of my life, no one knows I have HIV	En muchos lugares que frecuento nadie sabe que tengo VIH
2	I feel guilty because I have HIV	Me siento culpable porque tengo VIH
3	People’s attitudes make me feel worse about myself	Las actitudes de la gente me hacen sentir peor conmigo mismo
4	Telling someone I have HIV is risky	Decir a alguien que tengo VIH es riesgoso
5	People with HIV lose jobs when employers learn	Personas con VIH pierden su trabajo cuando sus empleadores se enteran de su diagnóstico
6	I work hard to keep my HIV a secret	Hago mucho esfuerzo para mantener en secreto que tengo VIH
7	I feel I’m not as good as others because I have HIV	Me siento que no soy tan bueno/a que otros porque tengo VIH
8	I never feel ashamed of having HIVc	Nunca me siento avergonzado porque tengo VIHc
9	People with HIV are treated like outcasts	Se trata a la gente con VIH como rechazados
10	Most people believe a person who has HIV is dirty	La mayoría de gente cree que una persona con VIH es sucia
11	Easier to avoid friendships than worry about telling	Es más fácil evitar amistades que preocuparse de como decirles
12	Having HIV makes me feel unclean	Tener VIH me hace sentir que no estoy limpio/a
13	I feel set apart, isolated from the rest of the world	Me siento aparte, aislado del resto del mundo
14	Most people think a person with HIV is disgusting	La mayoría de personas piensa que una persona con VIH es asquerosa
15	Having HIV makes me feel I’m a bad person	Tener VIH me hace sentir que soy una mala persona
16	Most with HIV are rejected when others learn	La mayoría de personas con VIH son rechazadas cuando otros se enteran que tienen VIH
17	I am very careful whom I tell that I have HIV	Soy muy cuidadoso a quien le digo que tengo VIH
18	Some people who know have grown more distant	Algunas personas que saben se han alejado
19	I worry about people discriminating against me	Me preocupo que las personas me discriminen
20	Most people are uncomfortable around someone with HIV	La mayoría de gente se incomodan con personas con VIH
21	I never feel I need to hide the fact I have HIVc	Nunca siento que tengo que esconder mi diagnósticoc
22	I worry that people may judge me when they learn	Me preocupo que personas me juzguen cuando se enteran
23	Having HIV in my body is disgusting to me	Tener VIH en mi cuerpo me disgusta
24	Hurt by how people reacted to learning I have HIV	La manera en que las personas reaccionaron cuando se enteraron que tengo VIH me ha lastimado
25	I worry people who know I have HIV will tell others	Me preocupa que las personas que saben que tengo VIH les digan a otros
26	I regret having told some people that I have HIV	Lamento haber dicho que tengo VIH a algunas personas
27	As a rule, telling others has been a mistake	Por lo general, decírselo a otros ha sido un error
28	People avoid touching me if they know I have HIV	Las personas evitan tocarme si saben que tengo VIH
29	People I care about stopped calling after learning	Las personas que quiero han dejado de llamarme al enterarse
30	Some told me HIV is what I deserve for how I lived	Algunos me han dicho que merezco VIH por como he vivido
31	Some people fear they’ll be rejected because of my HIV	Algunos tienen miedo que le van a rechazar por mi VIH
32	Don’t want me around their children once they know	Cuando se enteran no quieren que este cerca de sus hijos
33	People have physically backed away from me	Las personas se han alejado físicamente de mí
34	Some people act as though it’s my fault I have HIV	Algunas personas actúan como si fuera mi culpa tener VIH
35	Stopped socializing with some due to their reactions	He dejado de socializarme con algunas personas debido a sus reacciones
36	Have lost friends by telling them I have HIV	He perdido amigos cuando les decía que tengo VIH
37	I told people close to me to keep my HIV a secret	He dicho a personas cercanas a mi de mantener secreto que tengo VIH
38	People who know tend to ignore my good points	Las personas que saben, tiendan ignorar mis buenas características
39	People seem afraid of me because I have HIV	Las personas parecen tener miedo de mi porque tengo VIH
40	Knowing, they look for flaws in your character	Sabiendo, buscan imperfecciones en mi carácterd

1. ^aBerger et al. (2001), Copyright 2001. Research in Nursing & Health. Scale items reprinted with permission of Wiley & Sons, Inc.
2. ^bRespondents are asked to state how often each item is true for them: Casi siempre (Almost always) = 4; A veces (Sometimes) = 3; Rara a la vez (Rarely) = 2; Casi nunca (Almost never) = 1
3. ^cReverse scored
4. ^dFor consistency, the Spanish translation of this item is in the first person while the original version uses the second person. The Spanish translation corresponds to the following statement in English: “Knowing, they look for flaws in my character”