title: Measuring perceived stigma in female sex workers in Chennai, India.
abstract: Although sex work is highly stigmatized throughout the world, a limited body of research has examined stigma among female sex workers (FSWs). We developed a Sex Worker Stigma (SWS) Index to measure perceived stigma among 150 FSWs in Chennai, India. These women were at a median age of 35 years and reported, on average, having engaged in sex work for nine out of the previous 12 months. The two-factor structure of the index was verified in both exploratory and confirmatory factor analyses with acceptable goodness of fit. The final 10-item index comprises of two domains of perceived stigma from the community and perceived stigma from one's family. Cronbach's α coefficients were 0.87 and 0.88 for each domain, respectively. In regression analysis, we found that income from jobs other than sex work was correlated with decreased levels of perceived stigma from both the community (β = - 0.16; 95% CI: -0.30 and -0.02) and the family (β = - 0.24; 95% CI: -0.40 and -0.07); prior experience of accessing health care system increased perceived stigma from the community while heavier financial responsibility for the family was associated with lower perceived stigma from women's family. With the proposed SWS Index, we have a valid and reliable metric to document and track levels of perceived stigma among FSWs to assess the impact of stigma reduction interventions.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Su-Hsun
authors.initials: SH
authors.lastname: Liu
authors.forename: A K
authors.initials: AK
authors.lastname: Srikrishnan
authors.forename: Carla E
authors.initials: CE
authors.lastname: Zelaya
authors.forename: Suniti
authors.initials: S
authors.lastname: Solomon
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.forename: Susan G
authors.initials: SG
authors.lastname: Sherman
mesh_terms: D000328:Adult; D005163:Factor Analysis, Statistical; D005195:Family Relations; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D008875:Middle Aged; D011287:Prejudice; D011594:Psychometrics / Q000295:instrumentation; D012044:Regression Analysis; D011477:Sex Work / Q000523:psychology*; D057545:Social Stigma; D013240:Stereotyping; D055815:Young Adult