Buddhist Understanding and Reduction of Myanmar Experiences of HIV Stigma and Exclusion

Not Applicable

Completed

• Conditions: Hiv; Mindfulness; Stigma, Social
• Interventions: Behavioral: Stigma reduction

• Registration Number: NCT05126225
• Lead Sponsor: University of California, Los Angeles

Brief Summary

This project aims to explore a multi-leveled conceptualization of the effects of HIV stigma on HIV care engagement in Myanmar by conducting a mixed-method study.

Detailed Description

This project is to explore how Myanmar People Living With HIV (PLWH) experience and manage HIV stigma as inspired by Buddhist teaching, and to adapt an evidence-based stigma-reduction intervention to tailor treatment for the unique needs of Myanmar People Living With HIV.

A stigma-reduction intervention will be adopted to the needs of Myanmar People Living With HIV with six focus groups.

Study Timeline

• Study Start: 2020-07-01
• Study First Submitted: 2021-10-26
• Study First Submitted QC: 2021-11-16
• Study First Posted: 2021-11-18
• Primary Completion: 2023-11-19
• Study Completion: 2024-04-30
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-06
• Last Update Posted: 2024-08-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. HIV-Positive
2. Care by Myanmar Positive Group/CMRU
3. Living in Myanmar/Thailand
4. can stay in the period of intervention

Exclusion Criteria

1. Not HIV
2. Living outside of Myanmar/Thailand
3. Not care by MPG/CMRU
4. Cannot stay for the study period

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Protocol group	Stigma reduction	The intervention is modularized to eight weekly sessions of 2-hour group discussions. The facilitator applies the principle of Cognitive Behavior Therapy and provides psychoeducation to promote the awareness and understanding of HIV stigma as well as training to help participants acquire alternative coping skills, such as relaxation techniques. In five sessions, participants are introduced to the general cognitive-behavioral model of HIV stigma and are encouraged to track their thoughts, feelings, and behavioral responses when encountering external stigma or adverse events. The participants further learn to differentiate helpful and non-helpful coping strategies and practice applying helpful coping skills to effectively reduce their HIV stigma. In the other three sessions, participants further discuss more specific stigma that intersects with HIV stigma, including stigma in healthcare settings, access to social support, and available resources on the society levels.

Primary Outcome Measures

Name	Time	Method
Stigma	8 weeks	HIV stigma was assessed using the Perceived Stigma Scale (PSS), a 40-item scale. Each item is measured using a 4-point Likert type and it contains four factors: personalized stigma (18 items), disclosure concerns (12 items), negative self-image (9 items), and concern with public attitudes about people with HIV (12 items). Each factor (or subscale) is scored separately and the total score is computed by summing the 40 items. Reliability coefficient alphas ranged from 0.90-.93 for the factors and 0.96 for the total scale and 2-3 week test/retest correlations ranged from 0.89-.92 (Berger, Ferrans, \& Lashley, 2001).

Secondary Outcome Measures

Name	Time	Method
QOL	8 weeks	QOL was measured with Veterans SF (VSF)-12 Quality of Life. VSF-12 is a 12-item health questionnaire developed from the U.S. Each indicator variable is weighted for each of the response choices minus one. The VSF-12 questionnaires have been administered nationally by the Veterans Administration (VA) where there have been more than 2.5 million administrations since 1996. The eight domains are scored from 0 (worst) to 100 (best). The scores are linear transformed t-tests, with 50 as the mean and 10 as the standard deviation (SD) based on a normally distributed population. The VSF-12 was modified from the Medical Outcomes Study 36-item short-form (MOS SF-36) in domains that cover "role limitations due to physical and emotional problems" by replacement of dichotomized yes/no choices with a 5-point ordinal scale that ranges from "no, none of the time" to "yes, all of the time." These changes increase the precision and discriminatory validity of the role scales, PCS, and MCS.

Trial Locations

Locations (2)

Myanmar Positive Group; 🇲🇲 Yangon, Myanmar

Chiangmai Rajabhat University; 🇹🇭 Chiang Mai, Thailand