HIV-related stigma among healthcare providers hinders effective care delivery, particularly in culturally diverse settings. This study aimed to validate the Indonesian Healthcare Providers’ HIV Stigma Scale using a predictive structural equation modeling (SEM) approach with Partial Least Squares (PLS). A cross-sectional survey involving 138 healthcare providers in Bandung, Indonesia, was conducted to assess the scale’s psychometric properties. The finalized scale comprised 30 items across three constructs—stereotype, prejudice, and discrimination—demonstrating strong construct reliability, convergent validity, and discriminant validity. Results affirm the scale’s utility for assessing stigma, providing a foundation for targeted interventions to mitigate stigma and promote equitable healthcare practices. By offering a culturally adapted measurement tool, this study contributes to improving HIV care and reducing provider-based stigma in Indonesia.
CheungGWCooper-ThomasHDLauRS, et al. (2024) Reporting reliability, convergent and discriminant validity with structural equation modeling: A review and best-practice recommendations. Asia Pacific Journal of Management41(2): 745–783.
2.
DewiHEWilandikaASajodin (2021) Stigmas and discrimination by nurse towards patient with HIV/AIDS: A qualitative study. In: Proceedings of the 1st Paris Van Java International Seminar on Health, Economics, Social Science and Humanities (PVJ-ISHESSH 2020), 535, pp.448–450.
3.
DokaPJDanjinMDongsI (2017) HIV/AIDS-related stigma and discrimination among health-care providers in a tertiary health facility. Journal of Medical Science37: 44.
4.
Durosinmi-EttiOFriedBDubéK, et al. (2022) Sustainability of funding for HIV treatment services: A cross-sectional survey of patients’ willingness to pay for treatment services in Nigeria. Global Health Science and Practice10(2): 1–21.
5.
FeyissaGTWoldieMMunnZ, et al. (2019) Exploration of facilitators and barriers to the implementation of a guideline to reduce HIV-related stigma and discrimination in the Ethiopian healthcare settings: A descriptive qualitative study. PLoS One14(5): e0216887.
6.
Gázquez-LópezMGarcía-GarcíaIGonzález-GarcíaA, et al. (2023) Validation of the attitudes towards people living with HIV/AIDS scale in nursing students. BMC Nursing22(1): 245.
7.
GoffmanE (2009) Stigma: Notes on the Management of Spoiled Identity. New York: Simon and Schuster.
8.
HairJJrHairJFJrHultGTM, et al. (2021a) A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). Los Angeles: Sage Publications.
9.
HairJFHultGTMRingleCM, et al. (2021b) An introduction to structural equation modeling. In: Partial Least Squares Structural Equation Modeling (PLS-SEM) Using R. Classroom Companion: Business. Cham: Springer, pp.1–9. https://doi.org/10.1007/978-3-030-80519-7_1
10.
KalichmanSCShkembiBEl-KrabR (2023) Geometric approach to measuring intersectional stigma among black sexual minority men: Reliability and validity in an HIV prevention context. Sexual Health20(5): 441–452.
11.
KatzITBogartLMFitzmauriceGM, et al. (2021) The treatment ambassador program: A highly acceptable and feasible community-based peer intervention for South Africans living with HIV who delay or discontinue antiretroviral therapy. AIDS and Behavior25(4): 1129–1143.
12.
Lacombe-DuncanALogieCHNewmanPA, et al. (2020) A qualitative study of resilience among transgender women living with HIV in response to stigma in healthcare. AIDS Care32(8): 1008–1013.
13.
Ministry of Health of the Indonesia (2023) Executive Report on the Development of HIV/AIDS and Sexually Transmitted Infectious Diseases (STIs) for the First Quarter of 2023[Laporan Eksekutif Perkembangan HIV/AIDS dan Penyakit Infeksi Menular Seksual (PIMS) Triwulan I Tahun 2023]. Jakarta: Ministry of Health of the Indonesia.
14.
NixonECooperVDonettoS, et al. (2023) Co-designing health services for people living with HIV who have multimorbidity: A feasibility study. British Journal of Nursing32(11): S15–S21.
15.
OhrbachRBjonerJMetricQ, et al. (2012). Guidelines for Establishing Cultural Equivalency of Instruments. New York: University of Buffalo.
16.
OkpuaNCGodwinC A (2023) Healthcare providers in Nigerian hospitals and HIV-related stigma: A systematic review. Journal of Communication in Healthcare16(2): 170–179.
17.
Ortega-GonzalezEMartínez-RomaMDolores OceteM, et al. (2022) HIV screening and linkage to care in a health department in Valencia, Spain: Lessons learned from a healthcare quality improvement project. Medicine101(41): e30400.
18.
ParsonsJABondVANixonSA (2015) “Are We not Human?” Stories of stigma, disability and HIV from Lusaka, Zambia and their implications for access to health services. PLoS One10(6): e0127392.
19.
RiffelTChenS-P (2020) Stigma in healthcare? Exploring the knowledge, attitudes, and behavioural responses of healthcare professionals and students toward individuals with mental illnesses. Psychiatric Quarterly91: 1103–1117.
20.
SadiqIZUsmanAMuhammadA, et al. (2024) Sample size calculation in biomedical, clinical and biological sciences research. Journal of Umm Al-Qura University for Applied Sciences11: 133–141.
21.
SmallLAGodoySMLauC (2023) Perceptions of healthcare accessibility and medical mistrust among Black women living with HIV in the USA. Culture Health & Sexuality25(10): 1295–1309.
22.
StanglALEarnshawVALogieCH, et al. (2019) The health stigma and discrimination framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine17(1): 31.
23.
TaberKS (2018) The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education48(6): 1273–1296.
24.
TuranBBudhwaniHFazeliPL, et al. (2017) How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS and Behavior21(1): 283–291.
25.
TwimukyeAKingRSchlechW, et al. (2017) Exploring attitudes and perceptions of patients and staff towards an after-hours co-pay clinic supplementing free HIV services in Kampala, Uganda. BMC Health Services Research17(1): 580.
von ElmEAltmanDGEggerM, et al. (2014) The strengthening the reporting of observational studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. International Journal of Surgery12(12): 1495–1499.
28.
WagnerACHartTAMcShaneKE, et al. (2014) Health care provider attitudes and beliefs about people living with HIV: Initial validation of the health care provider HIV/AIDS Stigma Scale (HPASS). AIDS and Behavior18(12): 2397–2408.
29.
WilandikaA (2019) Health care provider stigma on people living with HIV/AIDS (PLWHA) in Bandung. Jurnal Keperawatan10(1): 7–15.
30.
WilandikaAYusufA (2023) The driving factors of social stigma against people with HIV/AIDS: An integrative review. Malaysian Journal of Medicine and Health Sciences19: 164–172.
31.
YendewaGAKpakaRASelluE, et al. (2023) Perceived and enacted HIV-related stigma in Eastern and Southern Sierra Leone: A Psychometric Study of an HIV Stigma Scale. medRxiv: the preprint server for health sciences. Epub ahead of print 12 July 2023. DOI: 10.1101/2023.07.07.23292152.
