R01TW012663

A Total School Approach Using Safeguarding to Address HIV-Related Stigma and Discrimination in Boarding Schools in Zambia - Project Summary

HIV-related stigma and discrimination operate at multiple socioecological levels and are known obstacles to optimal health and HIV outcomes.

In Zambia, some boarding school environments can be characterized by a culture of physical, verbal, and sexual abuse strongly linked to stigma and discrimination.

Despite this, little data exists on the impact of HIV-related stigma or stigma reduction interventions within school settings, with even less attention to boarding schools.

This study responds to the challenges of making Zambian boarding schools safe, stigma-free havens with reduced risk behaviors and improved health outcomes for learners, teachers, and support staff – both those living with HIV and those who are not.

Building on evidence that addressing HIV stigma and discrimination can disrupt the cycle of violence that is both cause and consequence of HIV risk and vulnerability, this study’s objective is to pilot test and evaluate a ‘Total School Approach’ to addressing HIV-related stigma and discrimination in boarding schools, embedded in a safeguarding framework.

We will co-create stigma reduction intervention packages with learners, teachers, staff, people living with HIV and other key stakeholders at two boarding schools in Zambia.

Learners, teachers, and staff will be trained to then deliver trainings to at least 80% of each school’s population.

For Aim 1, we will conduct a formative phase to adapt a ‘Total Facility Approach’ for addressing stigma and discrimination in healthcare to the Zambian boarding school setting, and to co-create an intervention package that uses a safeguarding approach, with the participating school communities.

For Aim 2, we will carry out a paired pre-post study to pilot test the impact of the intervention on stigma and discrimination and broader safeguarding measures.

We will implement a pre-post study design with outcomes measured through repeat paired surveys before and after the intervention.

For Aim 3, a mixed-methods process evaluation will explore how the school environment affects its population’s attitudes and behaviors and seek to understand implementation barriers and facilitators with a view to informing sustainability and scale-up.

The primary outcome measures will be self-reported experience of abuse and stigmatizing attitudes relating to HIV.

Mixed-methods approaches will provide insight into why different elements of the intervention worked/did not work and maximize learning about implementation of this approach to fostering a safe school environment, free from stigma and discrimination so as to improve HIV-related outcomes.

University Of Southern California

THE JOHN E. FOGARTY INTERNATIONAL CENTER (FIC) SUPPORTS RESEARCH AND RESEARCH TRAINING TO REDUCE DISPARITIES IN GLOBAL HEALTH AND TO FOSTER PARTNERSHIPS BETWEEN U.S. SCIENTISTS AND THEIR COUNTERPARTS ABROAD. FIC SUPPORTS BASIC BIOLOGICAL, BEHAVIORAL, AND SOCIAL SCIENCE RESEARCH, AS WELL AS RELATED RESEARCH TRAINING AND CAREER DEVELOPMENT. THE RESEARCH PORTFOLIO IS DIVIDED INTO SEVERAL PROGRAMS THAT SUPPORT A WIDE VARIETY OF FUNDING MECHANISMS TO MEET PROGRAMMATIC OBJECTIVES.

93.242 - Mental Health Research Grants

Fogarty International Center (FIC) [HHS - NIH]

National Institute of Mental Health (NIMH) [HHS - NIH]

California United States

State-Wide

Interventions for Stigma Reduction to Improve HIV/AIDS Prevention, Treatment and Care in Low- and Middle- Income Countries (R01 - Clinical Trial Optional) (PAR-23-190)

Amendment Since initial award the total obligations have increased 37% from $135,040 to $185,040.