Stigmatising attitudes among people offered home-based HIV testing and counselling in Blantyre, Malawi: construction and analysis of a stigma scale.

MacPherson, Peter, Webb, Emily L., Choko, Augustine T., Desmond, Nicola, Chavula, Kondwani, Napierala Mavedzenge, Sue, Makombe, Simon D., Chunda, Treza, Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 and Corbett, Elizabeth L. (2011) 'Stigmatising attitudes among people offered home-based HIV testing and counselling in Blantyre, Malawi: construction and analysis of a stigma scale.'. PLoS ONE, Vol 6, Issue 10, e26814.

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Abstract

Background
HIV/AIDS related stigma is a major barrier to uptake of HIV testing and counselling (HTC). We assessed the extent of stigmatising attitudes expressed by participants offered community-based HTC, and their anticipated stigma from others to assess relationship with HIV test uptake. From these data, we constructed a brief stigma scale for use around the time of HIV testing.

Methods and Findings
Adult members of 60 households in urban Blantyre, Malawi, were selected using population-weighted random cluster sampling and offered HTC with the option to self-test before confirmatory HTC. Prior to HTC a 15-item HIV stigma questionnaire was administered. We used association testing and principal components analysis (PCA) to construct a scale measure of stigma. Of 226 adults invited to participate, 216 (95.6%) completed questionnaires and 198/216 (91.7%) opted to undergo HTC (all self-tested). Stigmatising attitudes were uncommon, but anticipated stigma was common, especially fearing verbal abuse (22%) or being abandoned by their partner (11%). Three questions showed little association or consistency with the remaining 12 stigma questions and were not included in the final scale. For the 12-question final scale, Cronbach's alpha was 0.75. Level of stigma was not associated with previously having tested for HIV (p=0.318) or agreeing to HTC (p=0.379), but was associated with expressed worry about being or becoming HIV infected (p=0.003).

Conclusions
Anticipated stigma prior to HTC was common among both men and women. However, the high uptake of HTC suggests that this did not translate into reluctance to accept community-based testing. We constructed a brief scale to measure stigma at the time of HIV testing that could rapidly identify individuals requiring additional support following diagnosis and monitor the impact of increasing availability of community-based HTC on prevalence of stigma.

Item Type:	Article
Uncontrolled Keywords:	HIV; HIV testing; Self-testing
Subjects:	QY Clinical Pathology > QY 4 General works WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.7 Psychosocial aspects
Faculty: Department:	Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0026814
Depositing User:	Users 379 not found.
Date Deposited:	24 Oct 2012 09:34
Last Modified:	13 Nov 2019 11:21
URI:	https://archive.lstmed.ac.uk/id/eprint/3065

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