Herpes Attitude Scale

Abstract

The Herpes Attitude Scale (HAS) is a specialized 40-item instrument designed to quantitatively assess individuals’ beliefs and emotional responses regarding genital herpes. Developed by Katherine Bruce and Judith McLaughlin, the scale utilizes a 5-point Likert scale format. The HAS evaluates several critical psychosocial dimensions, including self-perception, attitudes towards others living with herpes, communication behaviors, relationship dynamics (both intimate and platonic), perceived coping efficacy, and common myths associated with the condition. The scale effectively discriminates between individuals holding positive attitudes and those exhibiting negative or stigmatizing attitudes toward genital herpes.

Initial development involved selecting 40 highly discriminatory items from a pool of 65 statements, based on expert panel review and rigorous item analysis using a sample of 250 undergraduate students. The resulting instrument is quick to administer, typically requiring less than 15 minutes to complete.

Keywords

Herpes Attitude Scale, HAS, Genital Herpes, Attitude, Stigma, Coping, Psychometrics, Sexual Health, College Students, Likert Scale.

Authors

Katherine Bruce, Judith McLaughlin

Purpose

The primary purpose of the Herpes Attitude Scale (HAS) is to provide a standardized, reliable measure of an individual’s affective and cognitive attitude concerning genital herpes. This assessment tool was created to understand and quantify the level of stigma, acceptance, and misconceptions held by respondents, initially focusing on college student populations.

The scale serves as a valuable tool for researchers and health educators aiming to evaluate the efficacy of educational interventions designed to reduce prejudice and increase understanding regarding sexually transmitted infections (STIs). By generating a standardized score, the HAS allows for clear differentiation between those with highly positive attitudes (indicating acceptance, knowledge, and high coping confidence) and those with negative attitudes (indicating fear, misinformation, and high stigma).

Construct

The HAS measures the multidimensional psychological construct of attitudes toward genital herpes. This construct is operationalized through several key sub-domains reflected in the scale items:

• Self-Concept and Coping: Feelings about personal self-worth and perceived ability to cope if diagnosed with genital herpes.
• Social Stigma and Acceptance: Attitudes regarding others who have herpes, including willingness to maintain friendships or pursue intimate relationships with infected individuals.
• Communication and Disclosure: Beliefs about the necessity and comfort level of communicating about herpes with partners or family.
• Myths and Misinformation: Assessment of adherence to common myths or misconceptions about transmission, severity, and visibility of the disease.

Validity

The validity of the Herpes Attitude Scale was primarily established through expert review of content and face validity during the instrument’s development phase (Bruce & McLaughlin, 1986). A panel of five expert judges was convened to assess the relevance, importance, and comprehensiveness of the scale items.

• Expert Panel Composition: The judges included diverse professionals critical to the subject matter: a physician, a registered nurse, two health educators, and crucially, a graduate student living with herpes.
• Content and Face Validity: This panel ensured that the scale comprehensively covered the intended domain of attitudes toward herpes and that the items were appropriate and easily understood by the target population.

Reliability

The internal consistency, a key aspect of psychometrics, was rigorously evaluated using a split-half reliability measure based on data collected from 148 undergraduate students enrolled in psychology and health education courses.

The HAS demonstrated high internal consistency, confirming that the items cohesively measure the underlying construct of herpes attitude. The calculated reliability coefficient using Cronbach’s alpha was reported as exceptionally high, reaching .91 (Bruce & McLaughlin, 1986; Bruce & Bullins, 1989). This strong alpha value indicates that the scale is highly reliable for measuring attitudes regarding genital herpes.

Factor Analysis

Specific details regarding confirmatory or exploratory factor analysis (EFA/CFA) of the sub-domains or underlying factors within the 40-item structure were not explicitly reported in the source development materials. However, the item analysis conducted during the selection process focused on item-total correlations (p < .001) to ensure each item contributed significantly to the overall discriminatory power of the total attitude score.

Instrument

Test Type: Attitudinal Scale / Self-Report Questionnaire

Format: 40-item, 5-point Likert scale.

Language Available: English (Original development language).

Population Group: Non-clinical population focused on sexual health attitudes.

Age Group: Primarily Young Adults (College age).

Population Details: Initial validation sample consisted of 250 undergraduate students in introductory psychology courses. The scale was designed for college students but is considered potentially applicable to other populations.

Test Methodology: Respondents select one of five response options for each item: Strongly Agree, Agree, Neither Agree nor Disagree, Disagree, or Strongly Disagree. The administration time is approximately 15 minutes.

Scoring

The Herpes Attitude Scale yields a single, standardized total attitude score ranging from 0 to 100. A higher score indicates a more positive attitude regarding genital herpes and the capacity to cope with the disease.

Scoring Procedure: The scale utilizes both direct and reverse scoring to account for the valence of the items:

• Positive Items (20 items: 2, 3, 4, 6, 9, 11, 12, 15, 17, 18, 19, 20, 21, 24, 25, 26, 27, 28, 38, 40): Scored directly (Strongly Agree = 5, Agree = 4, Neutral = 3, Disagree = 2, Strongly Disagree = 1).
• Negative Items (20 items: 1, 5, 7, 8, 10, 13, 14, 16, 22, 23, 29, 30, 31, 32, 33, 34, 35, 36, 37, 39): Scored in reverse order (Strongly Agree = 1, Strongly Disagree = 5).

Standardization Formula: The total raw score (X) is converted into the standardized HAS score using the following formula, where N is the number of items properly completed (typically N=40):

HAS score = (X − N)(100) / (N)(4)

Keywords

Attitudinal Assessment, STI Stigma, Psychological Measurement, Social Psychology, Health Education, Attitude Measurement, Genital Herpes.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: [email protected] (Katherine Bruce)

Correspondence Address: Katherine Bruce, Department of Psychology, UNC Wilmington, Wilmington, NC 28403, USA.

Permissions & Fee and Test Year

Permissions: Correspondence regarding permissions should be directed to the primary author, Katherine Bruce.

Fee: Not reported in the source material.

Test Year: Initial development and publication of the psychometric properties occurred in 1986 (Bruce & McLaughlin).

Reference’s

Bruce, K., & McLaughlin, J. (1986). The development of scales to assess knowledge and attitudes about genital herpes. The Journal of Sex Research, 22, 73–84.

Bruce, K. E. M., & Bullins, C. G. (1989). Students’ attitudes and knowledge about genital herpes. Journal of Sex Education and Therapy, 15, 257–270.

Items of the Herpes Attitude Scale

Instructions: For each of the following 40 statements, please note on the answer sheet whether you agree or disagree with the statements. Use the following scale:

SA: Strongly Agree With the Statement A: Agree With the Statement

N: Neither Agree nor Disagree With the Statement D: Disagree With the Statement

SD: Strongly Disagree With the Statement

Each statement is numbered. Be sure to match the statement’s number with the number on the answer sheet. Please respond to all items on the questionnaire. There are NO right or wrong answers.

1. The thought of genital herpes is disgusting.

2. I would not feel dirty if I got genital herpes.

3. Genital herpes is not as scary as most people believe.

4. There are a lot of diseases that are worse than genital herpes.

5. People give genital herpes to others for revenge.

6. I could cope with having genital herpes.

7. If I had a roommate with genital herpes, I would move out.

8. Only bad people catch genital herpes.

9. I feel comfortable around friends who have genital herpes.

10. You can tell that someone has genital herpes just by looking at them.

11. I am pretty sure that I could handle having genital herpes if I caught it.

12. Having genital herpes is really no worse than having cold sores.

13. People who have genital herpes are looked down on.

14. I do not like to use public restrooms because I might catch genital herpes there.

15. I could remain calm if I found out that I had gotten genital herpes.

16. A person who has genital herpes got what s/he deserves.

17. If I had genital herpes, I would tell a potential sex partner.

18. There is more to a person who has genital herpes than the fact that s/he has genital herpes.

19. I would not avoid a friend if I found out that s/he had genital herpes.

20. I would consider marrying someone who has genital herpes.

21. People who have genital herpes should be treated the same as anyone else.

22. I would feel self-conscious if I got genital herpes.

23. If I found out that my sexual partner had genital herpes, I would never speak to him/her again.

24. The “new sexual leprosy” is an inappropriate term for genital herpes.

25. Catching genital herpes would not be the worst thing that could happen to me.

26. I would not be ashamed if I got genital herpes.

27. People who have genital herpes are worth getting to know.

28. Genital herpes is a manageable disease.

29. I think that people who have genital herpes are too sexually active.

30. If I caught genital herpes, I would consider suicide.

31. People who have genital herpes should never have sex again.

32. I would be embarrassed to tell anyone if I had genital herpes.

33. Only unclean people catch genital herpes.

34. If I got genital herpes, no one would want to marry me.

35. If I got genital herpes, I would not want to have children.

36. Everyone would know if I got genital herpes.

37. People who have genital herpes are promiscuous.

38. I could discuss genital herpes with my parents.

39. If I asked a friend a question about genital herpes, s/he would think that I had genital herpes.

40. I would date a person known to have genital herpes.