ABSTRACT:
The stigma related to HIV has been extensively studied over the years, resulting in a variety of scales and instruments developed to measure stigma. However, despite significant progress in the development of HIV-related stigma scales, there is a scarcity of studies dedicated to measuring the stigma associated with the use of PrEP. Although effective, the use of this medication faces significant barriers due to social stigma and negative perceptions surrounding its use. The absence of specific instruments to measure stigma related to this prophylaxis may limit the understanding of the factors that hinder adherence to this prevention strategy. This study aimed to describe the cross-cultural adaptation into Brazilian Portuguese of a scale for assessing stigma among HIV PrEP users. Through a systematic review of five databases (Medline, Embase, CENTRAL, LILACS), 54 full articles were selected, which presented scales on stigma related to PrEP use. In total, five articles were selected, and the scales contained in them were sent for translation by a specialist. Consensus rounds with an epidemiologist, a nurse, and a health graduate were conducted to select the stigma domains found in the scales and adapt them to the Brazilian context according to the researchers' perception. Subsequently, the constructed scale was applied to 180 PrEP users at Specialized Care Services in Salvador, Brazil. The adapted scale consists of 49 items, using 4-point Likert-type responses. These items focus on three main dimensions of stigma: community, perceived, and internalized, which can be used independently to assess stigma. Feasibility was observed in the application of the scale. Having a validated Brazilian scale for PrEP-related stigma can provide researchers with an instrument capable of assessing stigma and its relationship with knowledge, acceptance, and adherence to PrEP.