Step UP! To Stamp Out Stigma: adapting and testing a bystander intervention to reduce HIV-related stigma

Aim: HIV-related stigma is a traumatizing experience operating across socioecological levels. Few interventions have combined multiple methods of stigma reduction into a comprehensive approach. This study adapted bystander training to the context of HIV-related stigma and pilot tested the model. Subjects and methods: The study drew upon the team’s prior research to create an adapted bystander intervention. Thirty-nine participants met in three separate workshop sessions, which consisted of didactic training, group discussions, and contact between people living with HIV (PLHIV) and their friends/family members, and healthcare workers. Participants completed pre-/post-intervention questionnaires that included demographic characteristics and standardized measures of stigma and empowerment. A person living openly with HIV served as the moderator. The study’s principal investigator led a discussion to evaluate the workshop model. Results: The workshops were associated with decreased feelings of powerlessness but did not show any immediate effects on feelings of stigmatization. Subjects unanimously recommended requiring the training for all healthcare providers. Conclusion: The study showed the feasibility of adapting a bystander approach to HIV-related stigma. Interactive participation across different stakeholder groups allows for addressing various types of stigma and incorporating multiple evidence-based approaches to stigma reduction. Future research will incorporate further adaptations and test the approach using a large-scale randomized controlled trial.