Adaptation and validation of perceived HIV and TB stigma scales among persons with TB

BACKGROUND 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). METHODS 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. RESULTS 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). CONCLUSION Adapted scales to measure perceived HIV and TB stigma among PWTB in Uganda demonstrated promising psychometric properties by removing one and two items, respectively. .