Development of the Experiences of Sex Work Stigma Scale Using Item Response Theory: Implications for Research on the Social Determinants of HIV.

Development of the Experiences of Sex Work Stigma Scale Using Item Response Theory: Implications for Research on the Social Determinants of HIV.
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DOI:
10.1007/s10461-021-03211-1
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发表时间:
2021-11
期刊:
影响因子:
4.4
通讯作者:
Chan KS
Chan KS
中科院分区:
医学2区
文献类型:
--
作者:
Kerrigan D;Karver TS;Barrington C;Davis W;Donastorg Y;Perez M;Gomez H;Mbwambo J;Likindikoki S;Shembilu C;Mantsios A;Beckham SW;Galai N;Chan KS

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虽然艾滋病毒污名受到了极大的关注,但在测量相交的污名方面开展的工作有限。我们在多米尼加共和国(DR)和坦桑尼亚发展了性工作污名(ESWS)量表的经验。我们对每个国家的20名女性性工作者(FSW)进行了深入访谈,以确定量表领域,然后进行认知情况汇报访谈,以评估内容的有效性。这些项目是在DR(n = 211)和坦桑尼亚(n = 205)向FSW进行的调查中进行的。因素分析建立了四个性工作污名领域,包括:羞耻(内化)、尊严(抵制)、沉默(预期)和治疗(制定)。各领域的信度在0.81到0.93之间。使用项目反应理论(IRT),我们创建了特定于背景的领域分数,说明了不同国家之间项目功能的差异。ESWS领域与内化的艾滋病毒污名、抑郁、焦虑、性伴侣暴力和跨背景的社会凝聚力有关。ESWS是评估性工作污名的多个领域的第一个可靠和有效的量表,可以用来检查这种形式的交叉污名对不同环境中艾滋病毒相关结果的影响。
While HIV stigma has received significant attention, limited work has been conducted on the measurement of intersecting stigmas. We developed the Experiences of Sex Work Stigma (ESWS) scale in the Dominican Republic (DR) and Tanzania. We conducted in-depth interviews with 20 female sex workers (FSW) per country to identify scale domains followed by cognitive debriefing interviews to assess content validity. Items were administered in a survey to FSW in DR (n = 211) and Tanzania (n = 205). Factor analysis established four sex work stigma domains including: shame (internalized), dignity (resisted), silence (anticipated) and treatment (enacted). Reliability across domains ranged from 0.81 to 0.93. Using item response theory (IRT) we created context-specific domain scores accounting for differential item functioning between countries. ESWS domains were associated with internalized HIV stigma, depression, anxiety, sexual partner violence and social cohesion across contexts. The ESWS is the first reliable and valid scale to assess multiple domains of sex work stigma and can be used to examine the effects of this form of intersectional stigma on HIV-related outcomes across settings.
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