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Stigma Measures

Excerpted from Evidence-based Generic Tools for Operational Research on HIV, Carla Makhlouf Obermeyer (ed.), 2008 (forthcoming), Geneva: World Health Organization.

This toolkit focuses on quantitative methods of measuring stigma. Validated quantitative tools have the potential to provide standardized data on stigma and discrimination that can be compared across cultural and epidemiological contexts, as well as across programs. However, purely quantitative studies can miss rich and nuanced information that can be tapped using qualitative methods. “Triangulating” both quantitative and qualitative data can provide a more complete picture of stigma in a particular study, explain behaviors, or detect unintended consequences of interventions.

The types of questions that can be best answered through qualitative research are different from those that are typically answered using quantitative methods. Rather than measuring the extent of stigma, or testing hypotheses about the amount of change associated with an intervention strategy, qualitative methods are well suited to add contextual information or explore reasons why certain quantitative results were found. Examples of relevant qualitative research questions include:

  • Why do community members hold particular stigmatizing attitudes?
  • What is the origin or reasons for observed discriminatory behaviors?
  • How was a stigma reduction intervention received by the target populations?
  • Why did an intervention have a certain unexpected impact?
  • What would be the best way to implement certain stigma reduction activities (i.e., formative research)?

To answer these questions, a study might utilize focus groups or in-depth interviews with community members, local officials, or other key informants. Other creative, qualitative data collection methods (e.g., people living with HIV diaries, mapping, story-telling) can also be quite useful.

 

Domains of stigma and discrimination

Measures for inappropriate fear of contagion and resulting avoidance of people living with HIV

Measures for negative judgments of people living with HIV

Measures for enacted stigma (discrimination)

Measures for compounded/layered stigma

Measures for other aspects of stigma

How to use the survey items

Methodological issues for data collection

An example: Developing a stigma index in India

Example of a survey module

Additional survey items

HIV Stigma Scale

Working Report Measuring HIV Stigma: Results of a Field Test in Tanzania

 

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