Identifying EthnicRacial Differences on the HIV Stigma Scale Using Item Response Theory

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Identifying Ethnic/Racial Differences on the HIV
Stigma Scale Using Item Response Theory

• Deepa Rao, Ph.D., Northwestern University,
  Chicago, IL
• Email deepa-rao_at_northwestern.edu
• John B. Pryor, Ph.D., Illinois State University,
  Normal, IL
• Bambi W. Gaddist, Dr.P.H., South Carolina
  HIV/AIDS Council, Columbia, SC
• Randy Mayer, M.P.H., Iowa Department of Public
  Health, Des Moines, IA
• United States

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Background

• HIV Self Stigma is associated with
• Depression/Anxiety1
• Poor antiretroviral adherence2
• No studies comparing HIV Self Stigma across
  cultures

1Lee, Kochman, Sikkema, 2002 2Rintamaki, Davis,
Skripkauskas, Bennett, Wolf, 2006
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Aims

• To explore ethnic/racial differences in HIV
  Stigma
• On items of the HIV Stigma Scale
• On subscales of the HIV Stigma Scale

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Sample and Measures

• 224 Black 317 White PLWHA
• Iowa South Carolina, USA
• HIV Stigma Scale1
• 4 Subscales
• Personalized Stigma
• Disclosure Concerns
• Negative Self Image
• Concern with Public Attitudes

1Berger, Ferrans, Lashley, 2001
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Analyses

• Item response theory (IRT)
• Item level differences
• Multiple regression analyses
• Subscale level mean differences

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Results

• IRT revealed item level differences
• White respondents
• Felt interpersonal rejection
• Worried about keeping HIV status secret
• Black respondents
• Felt morally judged
• Experienced discrimination
• Multiple Regression no mean differences on 4
  subscales

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Personalized Stigma

• White participants
• Telling others I have HIV has been a mistake
• Black participants
• I feel set apart and isolated from the world
• People act as though its my fault I have HIV

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Disclosure Concerns

• White participants
• No one knows I have HIV
• I work hard to keep secret my HIV
• Black participants
• I worry people discriminating against me
• I never hide the fact that I have HIV
• People judge me when learning I have HIV

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Negative Self Image

• White participants
• I work hard to keep my HIV status secret
• Black participants
• I feel set apart and isolated from the world

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Concern with Public Attitudes

• White participants
• Easier to avoid friendships than telling
• PLWHA rejected when others find out
• People look for flaws in your character
• Black participants
• I feel set apart and isolated from the world
• People discriminating against me
• People act as though its my fault I have HIV

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Conclusions

• Use HIV Stigma Scale with caution
• Differences in wording/interpretation of items
• Black PLWHA more attuned to discrimination
• Experiences of discrimination
• Racial socialization/identity development

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Deepa Rao, Ph.D. Institute for Healthcare
Studies Feinberg School of Medicine Northwestern
University deepa-rao_at_northwestern.edu