Pilot Outcomes of Maisha: An HIV Stigma Reduction Intervention Developed for Antenatal Care in Tanzania.

Pilot Outcomes of Maisha: An HIV Stigma Reduction Intervention Developed for Antenatal Care in Tanzania.
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DOI:
10.1007/s10461-020-03093-9
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发表时间:
2021-04
期刊:
影响因子:
4.4
通讯作者:
Mmbaga BT
Mmbaga BT
中科院分区:
医学2区
文献类型:
--
作者:
Watt MH;Minja L;Knettel BA;Mwamba RN;Osaki H;Ngocho JS;Kisigo GA;Renju J;Vissoci JRN;Sao SS;Mmbaga BT

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艾滋病毒污名化是遏制艾滋病毒传播和改善艾滋病毒感染者生活质量的一个长期障碍。我们开发并试点测试了Maisha,这是一种在产前护理(ANC)中减少艾滋病毒污名的干预措施,有两个目标:1)在艾滋病毒感染者中,减少内化和预期的艾滋病毒污名,随后改善艾滋病毒护理参与,2)在艾滋病毒血清阴性的个体中,减少艾滋病毒污名化态度。我们招募了1039名女性和492名男性伴侣参加首次ANC预约,并将他们随机分配到标准护理或Maisha干预。所有女性艾滋病毒感染者(WLHIV)和一部分艾滋病毒阴性参与者完成了为期3个月的随访评估。三次Maisha会议的参与率很高(99.6%,92.8%,89.3%),几乎所有参与者都对干预内容(99.8%)和咨询师(99.8%)表示满意。在55名WLHIV患者中,护理参与结果没有因条件而异。在293名HIV阴性的参与者中,Maisha参与者在污名态度测量的道德判断子量表中有显著更大的下降(p<0.001),但不是社交距离子量表。在产前护理机构,妇女及其伴侣定期接受艾滋病毒检测,是解决艾滋病毒污名化问题的理想场所。Maisha干预是可行的和可接受的,并对艾滋病毒污名化的态度。需要进行全面试验,以检查对艾滋病毒结果的影响;应考虑修改干预措施,以减少艾滋病毒感染者的社会疏远。
HIV stigma is a persistent barrier to curbing the spread of HIV and improving quality of life for people living with HIV. We developed and pilot tested Maisha, an HIV stigma reduction intervention in antenatal care (ANC) with two objectives: 1) among individuals living with HIV, reduce internalized and anticipated HIV stigma, with subsequent improvements in HIV care engagement, and 2) among individuals who are HIV-seronegative, reduce HIV stigmatizing attitudes. We enrolled and baselined 1039 women and 492 male partners presenting to a first ANC appointment and randomized them to standard of care or the Maisha intervention. All women living with HIV (WLHIV) and a subset of HIV-negative participants completed a 3-month follow-up assessment. Participation in the three Maisha sessions was high (99.6%, 92.8%, 89.3%), and nearly all participants noted satisfaction with the intervention content (99.8%) and counselor (99.8%). Among 55 WLHIV, care engagement outcomes did not differ by condition. Among 293 HIV-negative participants, Maisha participants had significantly greater reductions in the moral judgment sub-scale of the stigma attitudes measure (p<.001), but not the social distancing subscale. The ANC setting, where women and their partners are routinely tested for HIV, is an ideal venue for addressing HIV stigma. The Maisha intervention was feasible and acceptable, and had an impact on HIV stigma attitudes. A full trial is needed to examine impacts on HIV outcomes; modifications to the intervention should be considered to reduce social alienation of PLWH.
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