Psychometric Validation of a Scale to Assess Culturally-Salient Aspects of HIV Stigma Among Women Living with HIV in Bot
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ORIGINAL PAPER
Psychometric Validation of a Scale to Assess Culturally‑Salient Aspects of HIV Stigma Among Women Living with HIV in Botswana: Engaging “What Matters Most” to Resist Stigma Lawrence H. Yang1,2 · Ari R. Ho‑Foster3,4 · Timothy D. Becker5 · Supriya Misra1 · Shathani Rampa6 · Ohemaa B. Poku7 · Patlo Entaile8 · Melody Goodman1 · Michael B. Blank9
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Perceived stigma deters engagement in HIV care and is powerfully shaped by culture. Yet few stigma measures consider how cultural capabilities that signify “full personhood” could be engaged to resist stigma. By applying a theory conceptualizing how culturally-salient mechanisms can worsen or mitigate HIV stigma in relation to “what matters most” (WMM), we developed the WMM Cultural Stigma Scale for Women Living with HIV in Botswana (WMM-WLHIV-BW) and psychometrically evaluated it among 201 respondents with known and unknown HIV status. The two subscales, Cultural Factors Shape Stigma (CFSS) and Cultural Capabilities Protect against Stigma (CCPS) were reliable (both 𝛼 = 0.90 ). Among WLHIV, the CFSS Subscale showed initial construct validity with depressive symptoms (r = .39, p = .005), similar to an established HIV stigma scale, whereas the CCPS Subscale showed initial construct validity with self-esteem (r = .32, p = .026) and social support number (r = .29, p = .047), suggesting that achieving local cultural capabilities mitigates stigma and is linked with positive psychosocial outcomes. This culturally-derived scale could help WLHIV in Botswana experience improved stigma-related outcomes. Keywords HIV/AIDS · Stigma · Culture · Scale · Psychometrics · Measurement · Intersectionality Dr. Yang and Mr. Ho-Foster shared equally in first-authorship. * Lawrence H. Yang [email protected] 1
School of Global Public Health, New York University, 715 Broadway, New York, NY 10003, USA
2
Mailman School of Public Health, Columbia University, New York, NY, USA
3
Faculty of Medicine, University of Botswana, Gaborone, Botswana
4
Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
5
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
6
Department of Psychology, University of Botswana, Gaborone, Botswana
7
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
8
Botswana-UPenn Partnership, Gaborone, Botswana
9
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
13
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AIDS and Behavior
Resumen El estigma percibido detetiza la participación en la atención de VIH y está fuertemente moldeado por la cultura. Sin embargo, pocas medidas de estigma consideran cómo las capacidades culturales que significan “personalidad plena” podrían ser utilizadas para resistir el estigma. Mediante la aplicación de una teoría que conceptualiza cómo los mecanismos culturalmente destacados p
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