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.

HIV 污名化对临床结果具有深远影响，并破坏 HIV 感染者 (PLWH) 的生活质量。在 HIV 阴性个体中，关于 HIV 的错误信息和偏见态度会助长耻辱感，并助长对 PLWH 的歧视。产前保健 (ANC) 以普及 HIV 检测为重点，为解决 HIV 污名问题提供了一个独特的切入点。本研究描述了一项咨询干预的发展，以解决在坦桑尼亚参加首次 ANC 预约的妇女及其伴侣对 HIV 的耻辱感。为干预提供信息的形成性工作包括对 32 名孕妇和产后妇女（感染 HIV 的妇女和 HIV 阴性的妇女）和 20 名医护人员的定性访谈。使用主题分析方法对数据进行迭代分析，以确定干预目标。Maisha（斯瓦希里语中的“生命”），包括三节由 HIV 耻辱框架和认知行为疗法提供信息的课程：HIV 检测前的视频和简短咨询课程，以及针对 HIV 血清检测呈阳性的人，另外两节基于视频内容。干预的试点测试正在进行中。在第一次 ANC 就诊时解决 HIV 污名化问题可以帮助 HIV 感染者克服与污名化相关的障碍，以启动和维持 HIV 护理，并可以减少 HIV 检测呈阴性的人的污名化态度。