Nurses’ Attitudes About HIV/AIDS Scale—Version 2

Nurses’ Attitudes About HIV/AIDS Scale—Version 2‌

DEBORAH BRAY PRESTON,The Pennsylvania State University

ELAINE WILSON YOUNGMassachusetts General Hospital Institute of Health Professions

PATRICIA BARTHALOW KOCHThe Pennsylvania State University

ESTHER M. FORTIMedical University of South Carolina

The Nurses’ Attitudes About HIV/AIDS Scale (NAAS) is a paper-and-pencil test designed to assess nurses’ attitudes about people living with HIV/AIDS (PLWHAs; homosexuals, intravenous drug users, and women), nursing care concerns, and societal/professional concerns. It is a 1997 revision of the original NAAS (Preston, Young, Koch, & Forti, 1995).

Suggested applications of the NAAS are: (a) as a descriptive tool to investigate HIV/AIDS-related attitudes in a variety of nursing populations, (b) as a means of describing models of nursing practice behavior related to PLWHAs,

(c) as a means of predicting practice outcomes related to care of PLWHAs in varying nursing populations—specifically the use of Standard Precautions, (d) as a needs assessment for educational programming related to HIV/AIDS, and (e) as an evaluative tool to assess attitude change as the result of educational programming. In addition, adaption of the NAAS for use with other health care providers, that is, health educators, social workers, and physicians, is recommended.


The scale comprises 45 items pertaining to Homosexuality (12 items), Women with HIV (4 items), IV Drug Abusers (9 items), Nursing Care Concerns (8 items), and Social/ Professional Issues (12 items). The scale should be administered in its entirety and not as a series of subscales. We suggest that the items be randomly ordered to avoid response bias.

Response Mode and Timing

Respondents indicate their degree of agreement/disagreement with the statements on a scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). The scale requires approximately 20 minutes to complete.


For the Homosexuality items, reverse score Items 2, 7, 11, and 12. For the items on Women with HIV, reverse score Items 2 and 3. For the items pertaining to IV Drug Abusers, reverse score Items 3, 4, 5, and 7. For the Nursing Care Concerns, reverse score Items 1, 2, 6, 7, and 8. For the Social/Professional Issues, reverse score Items 1, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12. After adding all scores, possible scores range from 45 to 225, with higher scores indicating greater tolerance toward or favorable attitudes about HIV/AIDS.


Cronbach’s alpha for the Homosexuality items is .95, for the Women items, α = .64, for the IV Drug Abusers sub- scale, α = .75, for the Nursing Care Concerns, α = .80, and for the Social/Professional Issues, α = .82.


Nurses’ Attitudes About HIV/AIDS Scale—Version 2

The following are some statements regarding opinions about HIV/AIDS and PWAs. There may be no “right” or “wrong” response. Place the number from the scale that best represents your reaction in the space provided.

  1. Strongly Agree 4 Disagree

  2. Agree 5 Strongly Disagree

  3. Neither Agree nor Disagree


    1. Homosexual men should be given social equality. 1.              

    2. Male homosexuality is obscene and vulgar. 2.              

    3. The homosexual civil rights movement is positive for society. 3.              

    4. The love between two males is the same as heterosexual love. 4.              

    5. Homosexual men are a viable part of our society. 5.              

    6. I would be comfortable knowing that my clergy was a homosexual man. 6.              

    7. I feel disgusted when I consider the state of sinfulness of male homosexuality. 7.              

    8. I feel comfortable when I think that male homosexuality is a natural human occurrence. 8.              

    9. I feel confident that homosexual men are just as emotionally healthy as heterosexual men. 9.              

    10. I would feel comfortable if I learned that my son’s teacher was a homosexual man. 10.              

    11. Male homosexuality should be considered immoral. 11.              

    12. I feel revolted when I think of two men engaged in private sexual behaviors with each other. 12.              


  1. Women with HIV ought to have equal access to health care services. 1.              

  2. I feel disgusted when I think of an HIV-infected woman. 2.              

  3. A woman with HIV deserves what she gets. 3.              

  4. I would feel comfortable giving nursing care to an HIV positive woman. 4.              

IV Drug Abusers:

  1. The government should provide free syringes to IV drug abusers. 1.              

  2. IV drug abusers are victims of society. 2.              

  3. I feel disgusted when I consider the immorality of IV drug abuse. 3.              

  4. IV drug abusers ought to be locked up. 4.              

  5. People who contract HIV through IV drug abuse should not be entitled to free medical care. 5.              

  6. People who shoot drugs cannot help themselves. 6.              

  7. I feel upset around IV drug abusers. 7.              

  8. IV drug abusers are mistreated in our society. 8.              

  9. I would feel comfortable giving nursing care to an IV drug abuser. 9.              

Nursing Care Concerns:

  1. I feel worried about the possibility of acquiring AIDS from patients. 1.              

  2. I am bothered that I might not be able to prevent myself from contracting AIDS. 2.              

  3. It is comforting to know that there isn’t much difference in caring for AIDS patients than caring for other

    terminally ill persons. 3.              

  4. I have enough information to protect myself against AIDS in my workplace. 4.              

  5. I worry about possible casual contact with a person with AIDS. 5.              

  6. I am fearful of caring for persons with AIDS because there is no cure. 6.              

  7. Nurses need to know the HIV antibody status of patients they are caring for. 7.              

  8. I am not bothered about possibly caring for an infant who was born HIV positive. 8.              

Social/Professional Concerns:

  1. Nurses who are HIV positive should be prevented from participating in direct patient care. 1.              

  2. Persons with AIDS are not dangerous to other people with whom they come in casual contact. 2.              

  3. I think the homosexual community has brought the problem of AIDS upon itself. 3.              

  4. I feel angry about possibly caring for a person with AIDS who contracted the disease through high-risk

    sexual behaviors. 4.              

  5. There is too much money spent on AIDS research. 5.              

  6. Persons with AIDS should be quarantined. 6.              

  7. Pregnant nurses should be excused from caring for persons with AIDS. 7.              

  8. Civil rights laws should be enacted to protect people with AIDS from job and housing discrimination. 8.              

  9. Activities that spread AIDS, such as some forms of sexual behaviors, should be outlawed. 9.              

  10. It distresses me to think that so many nursing procedures have to be changed or modified as a result of AIDS. 10.              

  11. Nurses should be allowed to refuse to care for a person with AIDS. 11.              

  12. Public school officials should not be required to accept an AIDS child into classes. 12.

Address correspondence to Deborah Bray Preston, Professor Emerita, The Pennsylvania State University, 3296 Shellers Bend, Unit 144, State College, PA 16801; e-mail: [email protected]


Preston, D. B., Young, E. W., Koch, P. B., & Forti, E. M. (1995). The Nurses’ Attitudes About AIDS Scale (NAAS): Development and psychometric analysis. AIDS Education and Prevention, 7, 443–454.