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The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania

Author

Listed:
  • Watt, Melissa H.
  • Knettel, Brandon A.
  • Knippler, Elizabeth T.
  • Kisigo, Godfrey
  • Ngocho, James S.
  • Renju, Jenny
  • Rogathi, Jane
  • Sao, Saumya S.
  • Minja, Linda
  • Osaki, Haika
  • Mwamba, Rimel N.
  • Mmbaga, Blandina T.

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.

Suggested Citation

  • Watt, Melissa H. & Knettel, Brandon A. & Knippler, Elizabeth T. & Kisigo, Godfrey & Ngocho, James S. & Renju, Jenny & Rogathi, Jane & Sao, Saumya S. & Minja, Linda & Osaki, Haika & Mwamba, Rimel N. & , 2020. "The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania," Evaluation and Program Planning, Elsevier, vol. 83(C).
    • Handle: RePEc:eee:epplan:v:83:y:2020:i:c:s0149718920301634
    DOI: 10.1016/j.evalprogplan.2020.101859
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    References listed on IDEAS

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    1. Kulkarni, S.P. & Shah, K.R. & Sarma, K.V. & Mahajan, A.P., 2013. "Clinical uncertainties, health service challenges, and ethical complexities of hiv 'test-and-treat': A systematic review," American Journal of Public Health, American Public Health Association, vol. 103(6), pages 14-23.
    2. Hailay Abrha Gesesew & Amanuel Tesfay Gebremedhin & Tariku Dejene Demissie & Mirkuzie Woldie Kerie & Morankar Sudhakar & Lillian Mwanri, 2017. "Significant association between perceived HIV related stigma and late presentation for HIV/AIDS care in low and middle-income countries: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-16, March.
    3. Eaton, L.A. & Cherry, C. & Cain, D. & Pope, H., 2011. "A novel approach to prevention for at-risk HIV-negative men who have sex with men: Creatinga teachable moment to promote informed sexual decision-making," American Journal of Public Health, American Public Health Association, vol. 101(3), pages 539-545.
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