Table 3_Measurement invariance of HIV-related stigma scales among men who have sex with men (MSM) and non-MSM populations: implications for comparative studies in China.docx

Background<p>Measurement invariance ensures that scales used in research measure the same constructs across different groups. As HIV-related stigma scales are increasingly used in studies involving men who have sex with men (MSM) and non-MSM populations, it is crucial to evaluate the equivalen...

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Main Author: Tianyue Mi (12310625) (author)
Other Authors: Xueying Yang (327694) (author), Guanghua Lan (570384) (author), Shan Qiao (646492) (author), Zhiyong Shen (344456) (author), Yuejiao Zhou (405838) (author), Xiaoming Li (7401) (author)
Published: 2025
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Summary:Background<p>Measurement invariance ensures that scales used in research measure the same constructs across different groups. As HIV-related stigma scales are increasingly used in studies involving men who have sex with men (MSM) and non-MSM populations, it is crucial to evaluate the equivalence of these measures. This study examines the measurement invariance of internalized, anticipated, and enacted HIV-related stigma scales between MSM and non-MSM populations in China.</p>Methods<p>Data were derived from two studies: a prospective cohort study with 193 MSM and 579 non-MSM, and a cross-sectional survey of 402 MSM. Participants completed the 8-item internalized, 9-item anticipated, and 16-item enacted HIV-related stigma scales. Confirmatory factor analysis was used to test measurement invariance by progressively adding equality constraints to the models for each stigma dimension.</p>Results<p>Partial scalar measurement invariance was achieved for the internalized stigma scale, allowing the intercepts of items 2, 3, and 6 to vary (χ<sup>2</sup> = 89.32, df = 43; CFI = 0.986; TLI = 0.981; RMSEA = 0.043, 95%CI [0.030, 0.056]; SRMR = 0.033), indicating that the zero points of item 2 (“I feel ashamed of having HIV”), item 3 (“Having HIV makes me feel unclean”), and item 6 (“I feel guilty because I have HIV”) were different between MSM and non-MSM. Partial residual measurement invariance was established for the anticipated stigma scale by allowing the residuals of item 2 to vary (χ<sup>2</sup> = 93.57, df = 66; CFI = 0.994; TLI = 0.993; RMSEA = 0.027, 95%CI [0.012, 0.038]; SRMR = 0.022), indicating that the item variance that could not be explained by the factor was different between MSM and non-MSM. For the enacted stigma scale, partial scalar invariance was achieved by allowing the threshold of item 7 to vary (χ<sup>2</sup> = 314.74, df = 219; CFI = 0.987; TLI = 0.986; RMSEA = 0.027, 95%CI [0.020, 0.034]; SRMR = 0.088), indicating that the threshold of item 7 was different between MSM and non-MSM.</p>Conclusion<p>The study supports the use of these HIV-related stigma scales for comparing MSM and non-MSM populations, though caution is needed as some items demonstrated partial measurement invariance. These findings provide a foundation for future research and interventions aimed at reducing HIV-related stigma across diverse groups.</p>