| Logie et al., 2019 |
PTI: Participatory Theatre Intervention |
The PTI involved two components.
Community animators from the theatre groups enacted the skits. The animators performed each play once to illustrate the situation and a particular experience of stigma. This initial enactment resulted in a crisis with no solution offered.
Each play was performed a second time, and one of the co-facilitators stopped the play at a key point where there was a challenge and invited one or more of the intervention participants to portray a more positive and supportive solution. The participants, then acted out a possible solution. |
Interpersonal |
- |
1. Understanding Perceptions of Negative Impacts of LGBT Stigma.
2. Change in Attitude or Perspective Through Self-Reflection
3. Change in Attitude or Perspective Through Learning
4. Participatory Theatre Format as Supporting Change
5. Ambivalence in Changing Attitude or Perspective |
1. Expand interventions to targeted groups
2. Integrate interventions into existing community events
3. Focus interventions on rural communities
4. consider mechanisms to address policy- and community-level changes in stigma to foster lasting attitudinal changes
5. Social-ecological approaches to PTI to help identify barriers and facilitators to attitudinal change. |
| Nyblade et al., 2020 |
Ghana “total facility” intervention |
Two-day participatory stigma-reduction training for all staff levels with delivery by staff and clients from the facilities who were trained as stigma-reduction facilitators.
The training includes 14 core activities.[@187059] |
Interpersonal |
Observed and perceived |
1. Fear of acquiring HIV while providing care for clients living with HIV improved significantly in the intervention versus comparison facilities, as did associated stigmatizing avoidance behaviors such as double gloving.
2. No statistically significant Difference-in-differences between the intervention and control facilities on the composite stigmatizing attitudes variable. |
Health facility stigma-reduction interventions should be accompanied by rigorous implementation science to ensure ongoing learning and adaptation to maximize effectiveness and long-term impact. |
| Miller et al., 2021 |
ACT: Advocacy and Other Community Tactics |
1. Awareness building employing instructional videos, written educational materials, conferences, and other communication platforms
2. Community mobilization
3. Documentation involving systematic collection and reporting of data on violations
4. Policy analysis and engagement
5. Self-stigma reduction using small-group workshops and discussion forum
6. Sensitization using small-group workshops and other training formats. |
Structural |
Ghana self-stigma |
1. Increased commitments to Equality in Access to HIV Care
2. improvements in access to HIV care through the creation of new resources or easing of access to existing resources
3. enhancement in the advocacy capacity
4. increases in the coverage and framing of issues pertinent to access to health care/human rights
5. informal changes to exclusionary practices
6. Formal Policy changes |
1. Synergistic effects of structural inventions when combined should be further explored
2. Structural interventions may benefit from being coupled with activities to address self-stigma and self-care |
| Keuroghlian et al., 2021 |
MARPI: (Most At Risk Populations Initiative) training model |
Provider training in cultural responsiveness and involvement of SGM peer educators
1. Equipping HIV and sexual healthcare staff with the knowledge, skills and empathy needed to serve SGM people
2. Increasing understanding of societal stigma’s relationship to health disparities
3. Cultivating staff’s insight into their own personal level of comfort and confidence serving SGM people
4. Fostering vigilance to keep personal attitudes towards SGM people separate
from professional behaviour
5. Applying key concepts and terminology for sensitive and effective communication
6. Promoting warmth and sincerity in service delivery
7. Raising awareness of verbal and nonverbal communication
8. Not trying to change people’s SGM identities and prioritizing flexibility, choice, and autonomy in care. |
Interpersonal |
- |
1. Anecdotally, SGM community partners have reported that the research clinic is inclusive and welcoming.
2. The clinical trial was completed with 90% retention rates for MSM and 81% retention for transgender women at 12 months. |
1. Online live trainings and technical assistance programmes and no-cost web-based educational resources may facilitate the scale-up of tailored HIV and sexual healthcare for SGM communities in rural areas.
2. Establish partnerships with local SGM communities |