Md Safaet Hossain Sujan, Ellern Eng Hui, Antoine Khati, Kamal Gautam, Kiran Paudel, Manisha Dhakal, Jeffrey A Wickersham, Roman Shrestha
Sexuality Research and Social Policy, November 2025. Abstract
Introduction: Globally, gay, bisexual, and other men who have sex with men (GBMSM) experience disproportionate levels of stigma, and Nepal is no exception. Unfortunately, a standardized and cross-culturally validated scale is unavailable to measure the multidimensional stigma among GBMSM in Nepal. Therefore, the present study aimed to validate and evaluate the psychometric properties of the Nepali version of Neiland’s sexual stigma scale (NNSSS) among GBMSM in Nepal. Methods: A cross-sectional survey was conducted among 842 GBMSM in Nepal. Participants completed the NNSSS, patient health questionnaire-9, generalized anxiety disorder scale-7, and the sleep quality scale. The NNSSS was analyzed in three stages: exploratory factor analysis (EFA) to discover underlying variables, confirmatory factor analysis (CFA) to evaluate model fit, and concurrent validity to determine how well it aligns with standardized measures. Results: Participants’ mean age was 27.6 years (SD 7.1). The EFA results yielded a two-factor structure of the NNSSS, including perceived and enacted stigma. The internal reliability of the scale and subscales was satisfactory (total scale alpha coefficient: 0.87, perceived sub-scale: 0.76, and enacted sub-scale: 0.87). The CFA results further validated the two-factor structure. The NNSSS demonstrated strong internal consistency and adequate concurrent validity. It showed greater correlations with anxiety, depressive symptoms, and sleep quality. Conclusion: The present study found that the NNSSS is a psychometrically sound and effective measure of perceived and enacted stigma among GBMSM in Nepal. Given the severe stigma attached to GBMSM in Nepal, this scale is critical for developing effective stigma-reduction interventions.