The development of Maisha,a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania |
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| Institution: | 1. Duke Global Health Institute, Duke University, Durham, NC, USA;2. Gilling School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA;3. Kilimanjaro Clinical Research Institute, Moshi, Tanzania;4. Kilimanjaro Christian Medical Centre, Moshi, Tanzania;5. Kilimanjaro Christian Medical University College, Moshi, Tanzania;6. London School of Hygiene and Tropical Medicine, London, UK;7. Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA;1. School of Economics and Management, Xidian University, No. 2 South Taibai Street, Xi’an, Shaanxi Province, PR China;2. Shaanxi Xi ''an Yanta District, Shida Road, Shaanxi Normal University, Xi’an, Shaanxi Province, PR China;1. Unit for Health Promotion Research, University of Southern Denmark, Niels Bohrs Vej 9-10, DK-6700, Esbjerg, Denmark;2. Department for Research and Development, University College South Denmark, Lembckesvej 3-7, DK-6100, Haderslev, Denmark;1. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, United States;2. Department of Health Policy and Management, Rollins School of Public Health, Emory University, United States;3. Hubert Department of Global Health, Rollins School of Public Health, Emory University, United States;1. Claremont Graduate University, United States;2. California State University, Los Angeles, United States |
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| Abstract: | HIV stigma has a profound impact on clinical outcomes and undermines the quality of life of people living with HIV (PLWH). Among HIV-negative individuals, misinformation and prejudicial attitudes about HIV can fuel stigma and contribute to discrimination against PLWH. Antenatal care (ANC), with its focus on universal HIV testing, provides a unique entry point to address HIV stigma. This study describes the development of a counseling intervention to address HIV stigma among women and their partners attending a first ANC appointment in Tanzania. Formative work to inform the intervention consisted of qualitative interviews with 32 pregnant and postpartum women (both women living with HIV and HIV-negative women) and 20 healthcare workers. Data were analyzed iteratively, using a thematic analysis approach, to identify intervention targets. The resulting intervention, Maisha (Swahili for “Life”), includes three sessions informed by the HIV Stigma Framework and Cognitive-Behavioral Therapy: a video and brief counseling session prior to HIV testing and, for those who test seropositive for HIV, two additional sessions building on the video content. A pilot test of the intervention is in process. Addressing HIV stigma at the first ANC visit can help individuals living with HIV to overcome stigma-related barriers to the initiation and maintenance of HIV care, and can reduce stigmatizing attitudes among those who test negative for HIV. |
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| Keywords: | Antiretroviral therapy (ART) HIV testing and counseling (HTC) Option B+ Prevention of mother-to-child transmission of HIV (PMTCT) Stigma reduction |
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