HIV stigma, worry of infection, and discrimination (S-Wi-D) among youths in South Africa

Purpose: This study developed and piloted a measurement tool to assess HIV related stigma and discrimination among youths in South Africa where HIV/AIDS epidemic has the hardest hit.  Methods: Disadvantaged youths in a camp-based HIV prevention program participated in the study.  An 18-item measurement tool (S-Wi-D) was developed in consultation with local HIV practitioners.  Results: A total of 441 youths participated, age ranged between 10-24 years, 55% were females.  The Cronbach alphas of the HIV stigma towards people living with HIV/AIDS - PLWHA (7-items), worry of infection (6-items), and support for coercive measures (discrimination) (5-items) were .826, .875, .804 respectively (CITC ranged among .486~.736).  Confirmatory factor analysis showed all items were loaded significantly on this three S-Wi-D sub-scales model with good fits (chi-/df=1.78; RMSEA=.053 [.041; .063]; NFI=.90; TLI=.94; CFI=.95; IFI=.95; GFI=.92; valid n=385).  Overall, participants rated low level of stigma and very low discrimination (or support for coercive measures) towards PLWHA, yet medium to high level of worry of infection.  At the end of the program, HIV stigma towards PLWHA had significantly decreased (sub-scale mean 14.16 vs. 12.10; p<.001), although worry of infection remained at similar level.  Conclusion: Findings showed this S-Wi-D measurement tool had satisfactory reliability and validity among youths in S. Africa, and was sensitive to detect changes on HIV stigma perceptions.  This study can help HIV researchers better understand the level of HIV stigma and provides a validated measurement suite to assess programs addressing HIV related stigma, worry, and discrimination.