Validation of a Brief Internalized Sex-work Stigma Scale among Female Sex Workers in Kenya

Bibliographic Data

ID10209462
AuthorsMelissa A Stockton (0000-0002-0737-7180, Vagelos College of Physicians and Surgeons, Columbia University, corresponding author), John Kraemer (Georgetown University), John D Kraemer (0000-0002-8769-3393, RTI International), Emmanuel Oga (RTI International), Joshua Kimani (0000-0003-2858-5007, University of Nairobi), David Kuria Mbote (0000-0002-9609-2397, The Dia Foundation for Research on Ageing Societies), David Mbote (Kuria Foundation for Social Enterprise), Caroline Kemunto (Survivors), Stella Njuguna (Kenya Medical Research Institute), Laura Nyblade (0000-0001-8067-4192, International Development Group, RTI International)
Year2021
Volume60
Issue1
Pages146-152
Publication date2021-10-08
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueThe Journal of Sex Research (JOURNAL)
Journal identifiersISSN: 0022-4499 • E-ISSN: 1559-8519
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/00224499.2021.1983752
PMID34622725
OpenAlexW3202509609
LanguageEN
Citations received8
References cited55

Female sex workers (FSW) often face severe stigma and discrimination and are extremely vulnerable to HIV and other sexually transmitted infections. In the fields of HIV and mental health, internalized stigma is associated with poor health care engagement. Due to the lack of valid, standardized measures for internalized sex work-related stigma, its dimensions and role are not well-understood. This study aimed to validate the six-item Internalized AIDS-Related Stigma Scale adapted to capture internalized sex work-related stigma by examining the scale's psychometric properties and performance among a cross-sectional, snowball sample of FSW (N = 497) in Kenya. While the original pre-hypothesized six-item model yielded acceptable CFI and SRMR values (CFI = 0.978 and SRMR = 0.038), the RMSEA was higher than desirable (RMSEA = 0.145). Our final four-item model demonstrated improved goodness of fit indices (RMSEA = 0.053; CFI = 0.999; and SRMR = 0.005). Both the pre-hypothesized six-item and reduced final four-item model demonstrated good internal consistency (Cronbach's alphas of 0.8162 and 0.8754, respectively). Higher levels of internalized stigma were associated with depression, riskier sexual behavior, and reduced condom use. This very brief measure will allow for reliable assessment of internalized stigma among FSW. Further investigation of internalized stigma among male sex workers, particularly the intersection of sex work-related and same-sex behavior-related stigmas, is needed

Environmental health · Family medicine · Female sex · Geography · Human immunodeficiency virus (HIV · Population · Psychiatry · Research methodology · Scale (ratio · Sex work · Sex workers · Stigma (botany · Work (physics · Clinical Psychology · Engineering · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Sex work and related issues