Stigmatising Attitudes among People Offered Home-Based HIV Testing and Counselling in Blantyre, Malawi: Construction and Analysis of a Stigma Scale



MacPherson, Peter ORCID: 0000-0002-0329-9613, Webb, Emily L, Choko, Augustine T, Desmond, Nicola ORCID: 0000-0002-2874-8569, Chavula, Kondwani, Mavedzenge, Sue Napierala, Makombe, Simon D, Chunda, Treza, Squire, S Bertel 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, 6 (10). e26814-.

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Abstract

<h4>Background</h4>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.<h4>Methods and findings</h4>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).<h4>Conclusions</h4>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
Additional Information: ## TULIP Type: Articles/Papers (Journal) ##
Uncontrolled Keywords: Humans, HIV Infections, Mass Screening, Self Care, Attitude, Stereotyping, Counseling, Adult, Female, Male, Young Adult, Social Stigma, Surveys and Questionnaires
Depositing User: Symplectic Admin
Date Deposited: 08 Jun 2016 15:01
Last Modified: 19 Jan 2023 07:35
DOI: 10.1371/journal.pone.0026814
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3001615