{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T15:22:53Z","timestamp":1770996173625,"version":"3.50.1"},"reference-count":34,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":683,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21-MH121314"],"award-info":[{"award-number":["R21-MH121314"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stigma and discrimination experiences attributable to multiple intersecting facets of the self (e.g. intersectional stigma) pose substantial challenges to accessing health services, including HIV prevention. While there have been theoretical advances in understanding multiple co-occurring stigmas, there are few psychometric instruments available to assess intersectional stigma. We have developed an approach to assessing intersectional stigma that conceptualises an intersection in geometric terms, defined as the line that connects points on two (or more) stigma dimensions and calculates scores derived from the geometric definition of intersecting lines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following pilot studies to derive items and response formats, we administered newly developed enacted stigma (24-items) and anticipated stigma (17-items) scales with attributions to race and sexual minority status for stigma experiences to a sample of 422 Black sexual minority men at risk for HIV recruited through social media platforms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The enacted and anticipated intersectional stigma scales, including subscales representing discrimination, interpersonal and felt stigma demonstrated evidence for reliability and construct validity. The enacted stigma scales were associated with medical mistrust, whereas the anticipated stigma scales predicted perceived barriers to using pre-exposure prophylaxis for HIV prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The intersectional stigma scales offer greater specificity in measuring stigma experiences attributed to race, sexual minority status and the intersection of racial\u2013sexual minority status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh23021","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T22:40:40Z","timestamp":1687387240000},"page":"441-452","source":"Crossref","is-referenced-by-count":4,"title":["Geometric approach to measuring intersectional stigma among black sexual minority men: reliability and validity in an HIV prevention context"],"prefix":"10.1071","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0912-5112","authenticated-orcid":true,"given":"Seth C.","family":"Kalichman","sequence":"first","affiliation":[{"name":"AInstitute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Storrs, CT 06269, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Shkembi","sequence":"additional","affiliation":[{"name":"AInstitute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Storrs, CT 06269, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee","family":"El-Krab","sequence":"additional","affiliation":[{"name":"AInstitute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Storrs, CT 06269, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"issue":"3","key":"2025102419150110200_R1","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1177\/1359105318820101","article-title":"Intersectional internalized stigma among Black gay and bisexual men: a longitudinal analysis spanning HIV\/sexually transmitted infection diagnosis.","volume":"26","author":"Earnshaw","year":"2021","journal-title":"J Health Psychol"},{"issue":"12","key":"2025102419150110200_R2","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1080\/13691058.2017.1312530","article-title":"Intersectional stigma among midlife and older Black women living with HIV.","volume":"19","author":"Sangaramoorthy","year":"2017","journal-title":"Cult Health Sex"},{"key":"2025102419150110200_R3","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00373","article-title":"Intersectional stigma and multi-level barriers to HIV testing among foreign-born black men from the Caribbean.","volume":"7","author":"Taylor","year":"2020","journal-title":"Front Public Health"},{"issue":"3 Suppl 2","key":"2025102419150110200_R4","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.16.3.18640","article-title":"Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis.","volume":"16","author":"Katz","year":"2013","journal-title":"J Int AIDS Soc"},{"key":"2025102419150110200_R5","article-title":"Diagnoses of HIV infection in the United States and dependent areas, 2018.","author":"CDC","year":"2020"},{"issue":"12","key":"2025102419150110200_R6","doi-asserted-by":"publisher","first-page":"3879","DOI":"10.1007\/s10461-018-2181-7","article-title":"Assessing HIV stigma on prevention strategies for black men who have sex with men in the United States.","volume":"22","author":"Sang","year":"2018","journal-title":"AIDS Behav"},{"issue":"11","key":"2025102419150110200_R7","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1080\/09540121.2017.1300633","article-title":"Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.","volume":"29","author":"Cahill","year":"2017","journal-title":"AIDS Care"},{"key":"2025102419150110200_R8","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.socscimed.2019.04.042","article-title":"\u201cThe fear of being Black plus the fear of being gay\u201d: the effects of intersectional stigma on PrEP use among young Black gay, bisexual, and other men who have sex with men.","volume":"232","author":"Quinn","year":"2019","journal-title":"Soc Sci Med"},{"issue":"sup2","key":"2025102419150110200_R9","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1080\/09540121.2018.1468012","article-title":"Intersectional health-related stigma in persons living with HIV and chronic pain: implications for depressive symptoms.","volume":"30","author":"Goodin","year":"2018","journal-title":"AIDS Care"},{"issue":"1","key":"2025102419150110200_R10","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1089\/lgbt.2013.0005","article-title":"LG(BT) persons in the second half of life: the intersectional influences of stigma and cohort.","volume":"1","author":"de Vries","year":"2014","journal-title":"LGBT Health"},{"issue":"1","key":"2025102419150110200_R11","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1246-9","article-title":"Challenges and opportunities in examining and addressing intersectional stigma and health.","volume":"17","author":"Turan","year":"2019","journal-title":"BMC Med"},{"key":"2025102419150110200_R12","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1080\/15298860701252203","article-title":"Measuring identity multiplicity and intersectionality: Hierarchical Classes Analysis (HICLAS) of sexual, racial, and gender identities.","volume":"7","author":"Stirratt","year":"2008","journal-title":"Self Identity"},{"key":"2025102419150110200_R13","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.socscimed.2018.05.001","article-title":"Perceptions of intersectional stigma among diverse women living with HIV in the United States.","volume":"208","author":"Rice","year":"2018","journal-title":"Soc Sci Med"},{"issue":"5","key":"2025102419150110200_R14","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1037\/ccp0000489","article-title":"Intersectional experiences, stigma-related stress, and psychological health among Black LGBQ individuals.","volume":"88","author":"Jackson","year":"2020","journal-title":"J Consult Clin Psychol"},{"issue":"3","key":"2025102419150110200_R15","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1080\/13557858.2018.1439896","article-title":"Gendered racism and the sexual and reproductive health of Black and Latina Women.","volume":"25","author":"Rosenthal","year":"2020","journal-title":"Ethn Health"},{"issue":"4","key":"2025102419150110200_R16","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1037\/a0015815","article-title":"Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health.","volume":"97","author":"Quinn","year":"2009","journal-title":"J Pers Soc Psychol"},{"key":"2025102419150110200_R17","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s10461-021-03437-z","article-title":"Finding the right angle: a geometric approach to measuring intersectional HIV stigma.","volume":"26","author":"Kalichman","year":"2022","journal-title":"AIDS Behav"},{"issue":"5","key":"2025102419150110200_R18","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1007\/s10865-022-00331-4","article-title":"A novel psychometric approach to assessing intersectional HIV stigma: the geometric intersectional stigma scales.","volume":"45","author":"Kalichman","year":"2022","journal-title":"J Behav Med"},{"issue":"1","key":"2025102419150110200_R19","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1089\/lgbt.2016.0083","article-title":"Understanding the influence of stigma and medical mistrust on engagement in routine healthcare among black women who have sex with women.","volume":"4","author":"Brenick","year":"2017","journal-title":"LGBT Health"},{"issue":"2","key":"2025102419150110200_R20","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1037\/a0023244","article-title":"Measuring multiple minority stress: the LGBT people of color microaggressions scale.","volume":"17","author":"Balsam","year":"2011","journal-title":"Cultur Divers Ethnic Minor Psychol"},{"issue":"6","key":"2025102419150110200_R21","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1007\/s10461-009-9593-3","article-title":"From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures.","volume":"13","author":"Earnshaw","year":"2009","journal-title":"AIDS Behav"},{"issue":"1","key":"2025102419150110200_R22","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1007\/s10865-019-00064-x","article-title":"HIV microaggressions: a novel measure of stigma-related experiences among people living with HIV.","volume":"43","author":"Eaton","year":"2020","journal-title":"J Behav Med"},{"issue":"3","key":"2025102419150110200_R23","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1097\/QAI.0b013e3181893ed0","article-title":"HIV risk behaviors in sub-Saharan Africa and Northern Thailand: baseline behavioral data from Project Accept.","volume":"49","author":"Genberg","year":"2008","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025102419150110200_R24"},{"key":"2025102419150110200_R25","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1007\/BF03372244","article-title":"The sell assessment of sexual orientation: background and scoring.","volume":"1","author":"Sell","year":"1996","journal-title":"J Gay Lesbian Bisexual Identity"},{"key":"2025102419150110200_R26","first-page":"17","article-title":"Correlates of internalized homophobia in a community sample of lesbians and gay men.","volume":"2","author":"Herek","year":"1997","journal-title":"J Gay Lesbian Med Assoc"},{"issue":"4","key":"2025102419150110200_R27","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1037\/cdp0000026","article-title":"When identities collide: conflicts in allegiances among LGB people of color.","volume":"21","author":"Sarno","year":"2015","journal-title":"Cultur Divers Ethnic Minor Psychol"},{"issue":"4","key":"2025102419150110200_R28","first-page":"502","article-title":"Adapting the everyday discrimination scale to medical settings: reliability and validity testing in a sample of African American patients.","volume":"21","author":"Peek","year":"2011","journal-title":"Ethn Dis"},{"issue":"5","key":"2025102419150110200_R29","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1093\/aje\/kwr287","article-title":"Racial\/ethnic differences in responses to the everyday discrimination scale: a differential item functioning analysis.","volume":"175","author":"Lewis","year":"2012","journal-title":"Am J Epidemiol"},{"issue":"5","key":"2025102419150110200_R30","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1007\/s10461-017-1690-0","article-title":"Stigma and conspiracy beliefs related to Pre-exposure Prophylaxis (PrEP) and interest in using PrEP among black and white men and transgender women who have sex with men.","volume":"21","author":"Eaton","year":"2017","journal-title":"AIDS Behav"},{"issue":"1","key":"2025102419150110200_R31","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.psychres.2010.08.018","article-title":"Validation of the Center for Epidemiologic Studies Depression Scale--Revised (CESD-R): pragmatic depression assessment in the general population.","volume":"186","author":"Van Dam","year":"2011","journal-title":"Psychiatry Res"},{"key":"2025102419150110200_R32","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: a self-report depression scale for research in the general population.","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Meas"},{"issue":"3","key":"2025102419150110200_R33","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1352\/1944-7558-114.3.172","article-title":"Utility of the Rosenberg self-esteem scale.","volume":"114","author":"Davis","year":"2009","journal-title":"Am J Intellect Dev Disabil"},{"issue":"6","key":"2025102419150110200_R34","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s11606-010-1288-y","article-title":"Validation of the group-based medical mistrust scale among urban black men.","volume":"25","author":"Shelton","year":"2010","journal-title":"J Gen Intern Med"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/20\/5\/441%20\/150112\/sh23021.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/20\/5\/441%20\/150112\/sh23021.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T23:15:10Z","timestamp":1761347710000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/20\/5\/441%20\/21672\/Geometric-approach-to-measuring-intersectional"}},"subtitle":[],"editor":[{"given":"Lisa","family":"McDaid","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,6,22]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10,11]]}},"URL":"https:\/\/doi.org\/10.1071\/sh23021","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,22]]}}}