Acceptability of an Internalized Stigma Reduction Intervention among Women Living with HIV in Tanzania

坦桑尼亚艾滋病毒感染妇女内部耻辱减少干预措施的可接受性

• 批准号: 9750963
• 负责人: Laura Nyblade
• 金额: $ 21.27万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9750963
• 关键词: Address; Africa; Area; Attention; Behavioral; CD4 Positive T Lymphocytes; Caring; Cell Count; Clinical; Communities; Development; Devices; Disclosure; Elements; Evaluation; Foundations; Fright; Gender; Goals; HIV; Health; Immunocompetence; Individual; Intervention; Linguistics; Literature; Measurement; Measures; Oral; Outcome; Pharmaceutical Preparations; Phase; Prevention; Property; Psychometrics; Quality of life; Randomized Clinical Trials; Research; Self Efficacy; Self Management; Site; Societies; Stereotyping; Tanzania; Testing; Touch sensation; Transportation; Treatment Efficacy; Voice; Woman; Work; antiretroviral therapy; base; coping; design; efficacy testing; experience; health care service; improved; insight; instrument; intervention effect; low income country; programs; psychosocial; self esteem; social; social stigma; theories; therapy design; virology; virtual

ABSTRACT/PROJECT SUMMARY The stigma associated with HIV, especially internalized stigma, yields a number of negative outcomes including non-adherence to antiretroviral therapy, non-engagement in care, poor self-efficacy for disclosure, and a diminished quality of life. Unfortunately, stigma is virtually synonymous with the experience of being a woman living with HIV in Tanzania, East Africa, and around the world. In Tanzania, despite the negative impact of stigma on HIV outcomes, interventions to mitigate the negative effects of internalized stigma associated with HIV, and instruments to measure intervention efficacy, are limited and critically needed. In Tanzania, the site for this study, approximately 810,000 women are living with HIV. Through development and rigorous testing of theoretically grounded, culturally sensitive, linguistically relevant, gender-specific internalized stigma reduction interventions, it is possible to help women successfully self-manage internalized stigma so they can achieve a variety of beneficial psychosocial, behavioral, and clinical outcomes including engaging in care, adhering to ART leading to an improved CD4+ T-cell counts and virologic suppression, and having an optimized quality of life. The internalized stigma reduction intervention to be evaluated for adaptation in this study, Maybe Someday: the Voices of Women Living with HIV, was identified to be effective in reducing internalized stigma among WLWH in the Southern USA. The Maybe Someday intervention, designed to work through the theory of narrative transportation, uses stories to help women understand elements of their own lives. In societies like Tanzania, where storytelling is an important part of the oral literature and culture, the use of stories can be used to help individuals acknowledge and reflect upon new truths in relation to self and their world producing transformations and insights that endure. Thus, the specific aims for this proposed study are to: Aim 1: assess the acceptability, and areas of necessary adaptation, of the internalized stigma reduction intervention, Maybe Someday, designed to mitigate the negative effects of internalized HIV- related stigma among women living with HIV in Tanzania; Aim 2: identify the preferred mode of intervention delivery among women living with HIV in Tanzania; Aim 3: evaluate the cultural and linguistic sensitivity and psychometric properties of a set of adapted measurement instruments essential to determining the efficacy of the Maybe Someday internalized stigma reduction intervention to be adapted for WLWH in Tanzania.

摘要/项目摘要 与艾滋病毒相关的耻辱，特别是内在的耻辱，会产生许多负面结果 包括不坚持抗逆转录病毒治疗、不参与护理、自我效能感差 信息披露和生活质量下降。不幸的是，耻辱实际上是耻辱的代名词。 坦桑尼亚、东非和世界各地一名感染艾滋病毒的女性的经历。在坦桑尼亚， 尽管耻辱对艾滋病毒结果产生负面影响，但仍需采取干预措施来减轻负面影响 与艾滋病毒相关的内在耻辱以及衡量干预效果的工具 有限且迫切需要。在本研究所在地坦桑尼亚，大约有 810,000 名妇女生活在 患有艾滋病毒。通过理论基础、文化敏感性、语言学的开发和严格测试 相关的、针对具体性别的内在耻辱减少干预措施，有可能帮助妇女 成功地自我管理内在的耻辱，以便他们能够实现各种有益的心理社会， 行为和临床结果，包括参与护理、坚持 ART 从而改善 CD4+ T 细胞计数和病毒学抑制，以及优化的生活质量。内在的耻辱 本研究将评估减少干预措施的适应性，也许有一天：妇女之声 感染艾滋病毒的人被认为可以有效减少南部地区 WLWH 的内在耻辱感 美国。 “也许有一天”干预旨在通过叙事传输理论发挥作用，使用 帮助女性了解自己生活要素的故事。在像坦桑尼亚这样讲故事的社会里 作为口头文学和文化的重要组成部分，故事的使用可以用来帮助个人 承认并反思与自我及其世界相关的新真理，从而产生转变 持久的见解。因此，这项研究的具体目标是： 目标 1：评估减少内在耻辱的可接受性以及必要的适应领域 干预措施，也许有一天，旨在减轻内化的艾滋病毒相关耻辱的负面影响 坦桑尼亚感染艾滋病毒的妇女； 目标 2：确定坦桑尼亚艾滋病毒感染妇女首选的干预方式； 目标 3：评估一组改编的文化和语言敏感性以及心理测量特性 测量工具对于确定“也许有一天”内在耻辱的功效至关重要 减少干预措施适用于坦桑尼亚的 WLWH。