HIV stigma is a persistent barrier to curbing the spread of HIV and improving quality of life for people living with HIV. We developed and pilot tested Maisha, an HIV stigma reduction intervention in antenatal care (ANC) with two objectives: 1) among individuals living with HIV, reduce internalized and anticipated HIV stigma, with subsequent improvements in HIV care engagement, and 2) among individuals who are HIV-seronegative, reduce HIV stigmatizing attitudes. We enrolled and baselined 1039 women and 492 male partners presenting to a first ANC appointment and randomized them to standard of care or the Maisha intervention. All women living with HIV (WLHIV) and a subset of HIV-negative participants completed a 3-month follow-up assessment. Participation in the three Maisha sessions was high (99.6%, 92.8%, 89.3%), and nearly all participants noted satisfaction with the intervention content (99.8%) and counselor (99.8%). Among 55 WLHIV, care engagement outcomes did not differ by condition. Among 293 HIV-negative participants, Maisha participants had significantly greater reductions in the moral judgment sub-scale of the stigma attitudes measure (p < .001), but not the social distancing subscale. The ANC setting, where women and their partners are routinely tested for HIV, is an ideal venue for addressing HIV stigma. The Maisha intervention was feasible and acceptable, and had an impact on HIV stigma attitudes. A full trial is needed to examine impacts on HIV outcomes; modifications to the intervention should be considered to reduce social alienation of PLWH.

HIV 污名是遏制 HIV 传播和改善 HIV 感染者生活质量的持久障碍。我们开发并试点测试了Maisha，这是一种在产前保健 (ANC) 中减少 HIV 污名的干预措施，其目标有两个：1) 在 HIV 感染者中，减少内化和预期的 HIV 污名，随后改善 HIV 护理参与，以及 2) 在个人中HIV 血清反应呈阴性的人，减少对 HIV 的污名化态度。我们招募了 1039 名女性和 492 名男性伴侣并进行了基线检测，这些伴侣首次接受 ANC 预约，并将他们随机分配到护理标准或 Maisha 干预组。所有感染 HIV 的女性 (WLHIV) 和一部分 HIV 阴性参与者完成了为期 3 个月的后续评估。参与三Maisha会话率很高 (99.6%、92.8%、89.3%)，几乎所有参与者都对干预内容 (99.8%) 和辅导员 (99.8%) 表示满意。在 55 名 WLHIV 中，护理参与结果没有因病情而异。在 293 名 HIV 阴性参与者中，Maisha参与者在耻辱态度测量的道德判断子量表（p <.001）上有显着更大的减少，但在社会距离子量表上没有。妇女及其伴侣定期接受 HIV 检测的 ANC 环境是消除 HIV 耻辱感的理想场所。麦莎_干预是可行和可接受的，并且对 HIV 污名化态度有影响。需要进行全面试验来检查对艾滋病毒结果的影响；应考虑对干预措施进行修改，以减少 PLWH 的社会疏离感。