The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania.


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Watt, MH; Knettel, BA; Knippler, ET; Kisigo, G; Ngocho, JS; Renju, J; Rogathi, J; Sao, SS; Minja, L; Osaki, H; Mwamba, RN; Mmbaga, BT

Published Date

  • December 2020

Published In

Volume / Issue

  • 83 /

Start / End Page

  • 101859 -

PubMed ID

  • 32795711

Pubmed Central ID

  • 32795711

Electronic International Standard Serial Number (EISSN)

  • 1873-7870

International Standard Serial Number (ISSN)

  • 0149-7189

Digital Object Identifier (DOI)

  • 10.1016/j.evalprogplan.2020.101859


  • eng