title: Stigmatizing attitudes towards people living with HIV/AIDS: validation of a measurement scale.
abstract: BACKGROUND
  Although stigmatization has long been recognized as a major obstacle to HIV prevention. The lack of a valid and reliable measurement tool for stigmatization is a major gap in the research. This study aimed to: 1) develop a scale of stigmatizing attitudes towards people living with HIV (SAT-PLWHA-S) and 2) demonstrate its reliability and validity.
  
  
  METHODS
  French and English-speaking experts (n = 21) from different professional communities (academics, practitioners) assessed the clarity and relevance of the proposed items. The psychometric properties of the SAT-PLWHA-S were assessed with a random digit dial population based telephone survey (n = 1,500) of respondents in Quebec, Canada. Analyses included exploratory and confirmatory factor analyses, correlations, multiple linear regressions, t-tests, hypothesis testing of factorial structure invariance, and Cronbach's alpha.
  
  
  RESULTS
  Confirmatory factor analysis (CFA) supported a 27-item structure with seven factors: 1) concerns about occasional encounters; 2) avoidance of personal contact; 3) responsibility and blame, 4) liberalism, 5) non-discrimination, 6) confidentiality of seropositive status, and 7) criminalization of HIV transmission. Cronbach's alphas indicate satisfactory internal consistency. An assessment of concurrent validity using Pearson's correlation and multiple linear regression shows that homophobia and HIV transmission knowledge are significant determinants of stigmatizing attitudes toward PLHIV. Discriminant validity (t-test) results suggest that the SAT-PLWHA-S can differentiate attitudes between different groups and indicates invariant factor structure across language.
  
  
  CONCLUSIONS
  The results of this study suggest that the SAT-PLWHA-S is a reliable and valid tool for measuring stigmatizing attitudes toward PLHIV and that it can contribute to a deeper understanding of HIV stigma.
authors.affiliation: Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada. beaulieu.marianne@gmail.com.
authors.forename: Marianne
authors.initials: M
authors.lastname: Beaulieu
authors.forename: Alix
authors.initials: A
authors.lastname: Adrien
authors.forename: Louise
authors.initials: L
authors.lastname: Potvin
authors.forename: Clément
authors.initials: C
authors.lastname: Dassa
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D004192:Discrimination, Psychological; D005163:Factor Analysis, Statistical; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011594:Psychometrics; D011792:Quebec; D015203:Reproducibility of Results; D057545:Social Stigma; D012959:Socioeconomic Factors; D013240:Stereotyping; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult