Adaptation and validation of perceived HIV and TB stigma scales among persons with TB
Stigma is a barrier to care for people affected by TB and HIV in Uganda, where these conditions remain endemic. While scales have been adapted and validated to measure stigma among TB-affected households in Uganda, there is a need for scales that measure the experiences of persons with TB (PWTB).
We adapted the Van Rie 12-item individual perspectives TB scale and 10-item individual perspectives HIV scale for use in Uganda through cross-cultural discussions with a multidisciplinary research team and four cognitive interviews with community health workers and PWTB. We then conducted a cross-sectional study administering each scale to 125 PWTB. We performed exploratory factor analysis, evaluated internal validity, and assessed convergent validity with perceived social support.
Exploratory factor analysis yielded a one-factor solution for both scales, with marginal model fit (standardised root mean square residual = 0.09 for TB, = 0.07 for HIV). There was evidence of convergent validity through a positive correlation of the TB (r = 0.22, p = 0.01) and HIV stigma (r = 0.22, p = 0.01) scales with perceived social support. Both scales had good internal validity (Cronbach’s α = 0.86 for TB, = 0.87 for HIV).
Adapted scales to measure perceived HIV and TB stigma among PWTB in Uganda demonstrated promising psychometric properties by removing one and two items, respectively.
Keywords: Kampala; Uganda; co-infection; psychometrics; scale
Document Type: Research Article
Affiliations: 1: Yale School of Medicine, New Haven, USA;, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA;, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda; 2: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda; 3: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA;, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 4: Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, USA; 5: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT;, Department of Social & Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA;, Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA; 6: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Clinical Epidemiology Unit, Department of Medicine, Makerere University, Kampala, Uganda; 7: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA;, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda;, Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT;, 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.
Publication date: March 1, 2025
The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.
The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.
- Editorial Board
- Information for Authors
- Subscribe to this Title
- International Journal of Tuberculosis and Lung Disease
- Public Health Action
- Ingenta Connect is not responsible for the content or availability of external websites
Receive new issue alert- Access Key
- Free content
- Partial Free content
- New content
- Open access content
- Partial Open access content
- Subscribed content
- Partial Subscribed content
- Free trial content