An adapted scale to measure perceived TB and HIV stigma during household contact investigation
Measuring stigma for TB and HIV in households undergoing contact investigation for TB is critical for understanding its impacts on health behaviours and identifying opportunities for intervention. However, standardised measurements for TB-HIV stigma in household contact investigations are limited.
We adapted and validated a household stigma scale in Uganda. This involved field testing measures from another setting with 163 household contacts of newly diagnosed TB patients, conducting cognitive interviews with seven household contacts, adapting scale items using cognitive interview data, and retesting the adapted scales in a random sample of 60 contacts. We assessed inter-item covariance and performed factor analysis to select the final scale items.
In whole-scale factor analysis, no cross-loading of items with scores ≥0.32 was found after the elimination of items based on covariance and symmetry. All TB items were loaded onto a single factor with scores ≥0.5, and all but one HIV item was loaded onto a second factor with scores ≥0.5. The final subscale internal consistency (Cronbach’s alpha) was 0.92 for TB and 0.89 for HIV.
The adapted TB-HIV stigma scale demonstrated acceptable psychometric properties and is substantially shorter and easier to administer than previous scales, making it suitable for programmatic research and evaluation.
Keywords: HIV; TB; contact investigation; stigma
Document Type: Research Article
Affiliations: 1: Departments of Epidemiology, and, Social & Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA;, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA; 2: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA;, Yale School of Medicine, New Haven, CT, USA; 3: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda; 4: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA;, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 5: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA;, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA;, Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, CT, USA;, Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA; 6: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Clinical Epidemiology & Biostatistics Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Publication date: September 1, 2024
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