# A Novel Intersectional HIV Stigma Measure in South Africa

> **NIH NIH F31** · UNIVERSITY OF CONNECTICUT STORRS · 2022 · $42,963

## Abstract

The social stigmatization of HIV impedes every step along the HIV continuum of care, including accessing HIV
care, adhering to antiretroviral therapy (ART), and sustaining HIV viral suppression. HIV stigma also intersects
with other stigmatized identities, such as gender and sexual orientation, with intersectional stigma creating
unique experiences and barriers to HIV care. Research investigating intersectional stigma is gaining traction in
high-income countries, however, studies of intersectional stigma across internalized, enacted, and anticipated
stigma mechanisms remains limited, and has not yet been reported in the low-income countries of sub-
Saharan Africa. Thus, while behavioral interventions to reduce the effects of HIV stigma are essential to ending
HIV epidemics, studies have not yet identified intersecting stigmatized identities and their impacts on ART
adherence in countries with high-HIV prevalence, such as South Africa. The absence of empirically validated
psychometric measures of intersectional HIV stigma is hampering research and interventions in places with the
greatest need. The proposed fellowship leverages an existing research infrastructure and project resources in
South Africa to conduct two-phases of intersectional stigma research. Phase 1 will conduct elicitation
interviews with women, sexual minority men, and heterosexual men receiving ART from an HIV clinic in Cape
Town, South Africa. The interviews will probe participants’ experiences with respect to intersecting stigmatized
identities. Insights gained from the interviews will inform the selection and tailoring of stigma scale items. An
independent sample of clinic patients will provide feedback on the items and the identified stigmatized
identities will be implemented in a novel approach to assessing intersectional stigma using a geometric
conceptualization of intersectionality grounded in the HIV Stigma Framework to assess intersectional
internalized, enacted, and anticipated stigma. In Phase 2, the newly developed intersectional stigma scales will
be tested for reliability, construct validity, and predictive validity in a short-term prospective study of women,
sexual minority men, and heterosexual men in HIV care and receiving ART. The completion of the study aims
will offer a novel approach to assessing intersectional HIV stigma in South Africa that will inform behavioral
interventions to promote ART uptake and adherence.

## Key facts

- **NIH application ID:** 10402635
- **Project number:** 1F31MH129182-01
- **Recipient organization:** UNIVERSITY OF CONNECTICUT STORRS
- **Principal Investigator:** Renee El-krab
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $42,963
- **Award type:** 1
- **Project period:** 2022-01-26 → 2025-01-25

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10402635

## Citation

> US National Institutes of Health, RePORTER application 10402635, A Novel Intersectional HIV Stigma Measure in South Africa (1F31MH129182-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10402635. Licensed CC0.

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