Measuring Sexual Behavior Stigma Among Cisgender Men Who Have Sex With Men: An Assessment of Cross-Country Measurement Invariance

Globally, cisgender men who have sex with men experience sexual stigma, but limited investigation of cross-population scale performance hinders comparisons. As measurement invariance is a necessary but seldom-established criterion of valid cross-cultural comparisons, we assessed invariance in scales of stigma related to sexual behavior across nine countries. This secondary analysis used data collected from adult (Mage = 29.6, SD = 12.5) cisgender men who have sex with men (n = 8,669) in studies from six West African, two Southern African, and one North American country from 2012 to 2016. A common item set assessed two sexual behavior stigma domains. A sequential process was used to test the factor structure and measurement invariance, which included multigroup confirmatory factor analyses. Individual countries, items, living with HIV, and disclosure were explored as possible sources of noninvariance. Goodness-of-fit statistics indicated adequate fit of the same two-factor model in seven of the nine countries. The chi-square difference test comparing a constrained and unconstrained seven-country model in which loadings and thresholds were freely estimated was significant ( p <.001), indicating metric and scalar noninvariance, but removing the United States provided evidence of invariance and freeing certain items led to a finding of partial invariance. Sexuality disclosure exhibited a direct relationship with select stigma items in several countries. Our findings point to the utility of the two stigma scale dimensions in making cross-country comparisons but also to the necessity of assessing invariance with explicit attention to several factors including differential disclosure of sexuality across contexts to ensure valid comparisons.