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Aparna Jain, MPH 1 Ratana Nuankaew 2 Pakprim Oranop na Ayuthaya 3 Kerry Richter, PhD 4

Success! Interventions that work to reduce HIV stigma & discrimination in communities: Results of an evaluation study in Thailand. Aparna Jain, MPH 1 Ratana Nuankaew 2 Pakprim Oranop na Ayuthaya 3 Kerry Richter, PhD 4 Anne Stangl , PhD 5. XIX International AIDS Conference

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Aparna Jain, MPH 1 Ratana Nuankaew 2 Pakprim Oranop na Ayuthaya 3 Kerry Richter, PhD 4

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  1. Success! Interventions that work to reduce HIV stigma & discrimination in communities: Results of an evaluation study in Thailand • Aparna Jain, MPH1 • RatanaNuankaew2 • PakprimOranopnaAyuthaya3 • Kerry Richter, PhD4 • Anne Stangl, PhD5 • XIX International AIDS Conference • July 25, 2012 • 1Johns Hopkins University; 2Population & Community Development Association (PDA); 3Pact Thailand; 4 Institute for Population and Social Research, Mahidol University; 5International Center for Research on Women

  2. Outline • Project Interventions • Study Design • Results • Conclusion

  3. Project Intervention

  4. Positive Partnership Project Phase II Goal • Increase quality of life of people living with HIV/AIDS • Increase income levels of people living with HIV • Reduce HIV stigma and discrimination in the community Two models • PPP clubs (PPPC) • Village development banks (VDB)

  5. Community Level Stigma Activities • Monthly meetings on banking day • HIV campaigns • IEC materials with key messages • Posters • Banking slips • Radio dramas 4. Funfairs – HIV/AIDS activity days Poster Funfair Banking slips with HIV key message Banking Day at VDB

  6. Project Sites & Duration • 11 PPP Clubs • Urban sites: Bangkok, Chiang Mai, and Chonburi • Rural sites: Chiang Rai, Nakonrachasima, KhonKaen • 12 Village Development Banks • Rural sites: Chiang Rai, Nakonrajasima, KhonKaen • April 2008–September 2010

  7. Study Design

  8. Community Dataset • Panel of 11 communities (6 PPPC & 5 VDBs) • Two cross-sectional surveys: • Baseline survey (October 2008 – March 2009) • Endlinesurvey (November 2010 – January 2011) • Sampling frames of households • Systematic random sampling of households • All individuals 15 years or older interviewed in each household

  9. Stigma Measures Previously validated stigma measures : • Fear-driven stigma • Fear of HIV transmission • Value-driven stigma • Shame associated with having HIV Scale development: • Principle component factor analysis at baseline, confirmed at endline • Predicted regression scores • Standardized scale to have a mean of 50 and standard deviation of 10, scores range from 0 to 100

  10. Results

  11. Respondent Characteristics • Respondent characteristics were similar at baseline & endline

  12. Correct HIV Knowledge Improved **p-value< 0.01; * p-value<0.05

  13. Fear-Driven Stigma Reduced **p-value< 0.01; * p-value<0.05

  14. Value-Driven Stigma (Shame) Reduced **p-value< 0.01; * p-value<0.05

  15. Percent Exposed to Interventions

  16. Percent Exposed to Intervention

  17. Multivariate Linear Analysis **p-value< 0.01; * p-value<0.05 ‡Adjusted for sex, marital status, age, education, residence, personal income, occupation, & media exposure to HIV messaging, baseline community average of fear

  18. Multivariate Linear Analysis **p-value< 0.01; * p-value<0.05 ‡Adjusted for sex, marital status, age, education, residence, personal income, occupation, & media exposure to HIV messaging, baseline community average of shame

  19. Findings • Correct knowledge of HIV improved • Fear and shame reduced • Greater correct HIV knowledge is associated with lower levels of fear and shame • Personally knowing someone living with HIV is associated with lower levels of fear but not shame • A combination of interventions for shifting community level fear and shame • HIV campaigns, Funfairs, IEC materials with key messages

  20. Conclusions • Involving people living with HIV in every step of the project • Important to tackle HIV stigma and discrimination using a combination of approaches • First step: increase correct HIV knowledge • Thailand HIV & AIDS Strategy 2012-2016 • To reduce HIV stigma and discrimination by half

  21. Acknowledgements • AruneeBunpabut & NungruthaiMongkolviboonpol, PDA Research and Evaluation Staff • UraiHomtawee, MaleeSunsiri, & EkachaiKumissara, PDA Program Staff • SupolSinghapoom, PACT M&E Officer • Laura Nyblade, RTI International • Department of Population, Family & Reproductive Health, JHSPH • The Bill & Melinda Gates Institute of Population & Reproductive Health, JHSPH

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