Preliminary development of a scale to measure stigma relating to sexually transmitted infections among women in a high risk neighbourhood

A pool of items was identified from qualitative and quantitative literature on sexual behaviour and STIs among women. Women attending a social evening program at a local community health clinic in a low-income neighbourhood with high prevalence of substance use were passively recruited to take part in a cross-sectional structured interview, including questions on sexual behaviour, sexual health and STI-related stigma. Exploratory factor analysis was used to identify stigma scales, and descriptive statistics were used to assess the associations of demographics, sexual and drug-related risk behaviours with the emerging scales.Three scales emerged from exploratory factor analysis – female-specific moral stigma, social stigma (judgement by others) and internal stigma (self-judgement) – with alpha co-efficients of 0.737, 0.705 and 0.729, respectively. In this population of women, internal stigma and social stigma carried higher scores than female-specific moral stigma. Aboriginal ethnicity was associated with higher internal and female-specific moral stigma scores, while older age (>30 years) was associated with higher female-specific moral stigma scores.Descriptive statistics indicated an important influence of culture and age on specific types of stigma. Quantitative researchers examining STI-stigma should consider incorporating these female-specific factors in order to tailor scales for women.Stigma has long been a part of our social existence, with the original Greek translation referring to a physical sign exposing a moral imperfection[1]. While in today's society the physical mark need not be present, the moral associations have remained intact. The topic of sexually transmitted infections (STIs) presents a good example of the dynamic and socially fluid nature of stigma, as opposed to the stationary, objectified definition it is sometimes given [2]. In relation to the categories of stigma outlined in Goffman's (1963) foundational work, STIs could be argued to cross