Measuring dimensions of HIV-related stigma among college students


HIV-related stigma remains a critical barrier to achieving national public health objectives including reducing HIV transmissions and retaining people living with HIV (PLHIV) in care. Adolescents and emerging adults are particularly vulnerable to HIV-related stigma and HIV transmission and, thus, are a priority population with regard to reducing stigma and increasing healthcare engagement. In order to reduce stigma, a better understanding of the multidimensional nature of HIV-related stigma is needed. The Stigmatizing Attitudes towards People Living with HIV/AIDS Scale (SAT-PLWHA-S) is a measure of HIV-related stigma developed in Canada. The current investigation sought to assess the validity and dimensionality of a revised SAT-PLWHA-S in young adults and in the United States. A revised SAT-PLWHA-S was completed by 2,686 college students in the southeastern United States. Confirmatory Factor Analysis indicated that the revised SAT-PLWHA-S measures a 6-factor structure consisting of: concerns of occasional encounters, avoidance of personal contact, responsibility and blame, liberalism, non-discrimination, and social policy. Overall, participants in our sample had low HIV-related stigma (M = 3.11; range 1–4, higher scores indicate less stigma). Scores demonstrated discriminant and concomitant validity with demographic characteristics, sexual behaviors, HIV testing history, and knowing PLHIV. We observed more stigmatizing attitudes regarding social policy, underscoring the need for public health practitioners and researchers to reduce HIV-related stigma related to criminalization and disclosure policies.

Stigma and Health

What is this paper about?

Understanding how to measure psychological concepts is important for public health theory development and practice. Some psychological concepts are not ‘visible.’ For example, depression isn’t directly visible. We measure how a person is depressed based on other behaviors (e.g., fatigue, lack of interest/motivation, sadness, etc.).

HIV-related stigma is a similar psychological concept that we cannot measure directly. This paper reports analyses of data from a survey of college students to understand their HIV stigma. We use statistical techniques to understand the different types perceptions including concerns of occassional encounters, avoiding contact with people living with HIV, and social policy about HIV.

How does this paper improve public health?

HIV-related stigma is a barrier to improving physical and mental health outcomes among people living with HIV, and is also a barrier to getting tested. Interventions and research are needed to better understand how to reduce HIV-related stigma so that we can improve health outcomes. Accurately (or validly) measuring HIV-related stigma is important for the future of this research. Our study provides evidence supporting the use of a 24-item survey to measure different types of HIV-related stigma among college students.


  • Is this paper peer reviewed? This paper is published in the journal Stigma and Health. This journal is managed by the American Psychological Association, and uses double-blind peer review where the authors and reviewers do not know each other’s identities.

  • Who paid for this project? Data reported in this paper were collected through a small research grant provided by the University of Florida Center for Undergraduate Research University Scholars Program, awarded to Tyler James under the mentorship of Dr. Sadie Ryan.

  • Was this study reviewed by an ethics board? Yes. This study received approval from the University of Florida’s Institutional Review Board.

  • Are there any conflicts of interest? There are no conflicts of interest.