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. 2022 Apr 14;22(1):754.
doi: 10.1186/s12889-022-13066-3.

Validity and reliability of the Neilands sexual stigma scale among Kenyan gay, bisexual, and other men who have sex with men

Christine J Korhonen  1 , Brian P Flaherty  2 , Elizabeth Wahome  3 , Pascal Macharia  4 , Helgar Musyoki  5 , Parinita Battacharjee  6   7 , Joshua Kimani  6   7 , Monika Doshi  7   8 , John Mathenge  4 , Robert R Lorway  7 , Eduard J Sanders  3   9 , Susan M Graham  10   3
Affiliations

Validity and reliability of the Neilands sexual stigma scale among Kenyan gay, bisexual, and other men who have sex with men

Christine J Korhonen et al. BMC Public Health. .

Abstract

Background: We evaluated the validity and reliability of the Neilands sexual stigma scale administered to 871 gay, bisexual, and other men who have sex with men (GBMSM) at two research locations in Kenya.

Methods: Using cross-validation, exploratory factor analysis (EFA) was performed on a randomly selected subset of participants and validated using confirmatory factor analysis (CFA) on the remaining participants. Associations of the initial and final stigma scale factors with depressive symptoms, alcohol use, and other substance use were examined for the entire dataset.

Results: EFA produced a two-factor scale of perceived and enacted stigma. The CFA model fit to the two-factor scale was improved after removing three cross-loaded items and adding correlated errors (chi-squared = 26.5, df 17, p = 0.07). Perceived stigma was associated with depressive symptoms (beta = 0.34, 95% CI 0.24, 0.45), alcohol use (beta = 0.14, 95% CI 0.03, 0.25) and other substance use (beta = 0.19, 95% CI 0.07, 0.31), while enacted stigma was associated with alcohol use (beta = 0.17, 95% CI 0.06, 0.27).

Conclusions: Our findings suggest enacted and perceived sexual stigma are distinct yet closely related constructs among GBMSM in Kenya and are associated with poor mental health and substance use.

Keywords: Factor analysis; Homophobia; Sexual and gender minorities; Social stigma; Surveys and questionnaires.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Exploratory factor analysis scree plot of the Neilands sexual stigma scale, n=435
Fig. 2
Fig. 2
Hypothesized Neilands sexual stigma scale model
Fig. 3
Fig. 3
Final 8-item sexual stigma scale model with standardized loadings
See this image and copyright information in PMC

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