Developing and Testing a Digital Health Tool for Intersectional Stigma Assessment and Reduction to Improve HIV Care in ART Centers in Nepal

What this Trial Is About

People living with HIV (PLWH) often face challenges in care due to intersectional stigma related to HIV, mental health, and other dimensions like sexual and gender minority status and ethnicity. This stigma leads to poor clinical outcomes globally. The study aims to evaluate the acceptability and feasibility of a digital health tool called INCLUDE, designed to assess and reduce intersectional stigma in ART centers in Nepal to improve HIV care engagement and outcomes. INCLUDE is a digital tool with three parts: a dynamic assessment strategy used during clinic visits to collect quantitative ratings and qualitative client perspectives on stigma; a dashboard that links stigma data with routine clinical data to identify stigma-related care barriers; and a collection of culturally appropriate, evidence-based stigma-reduction activities at individual, interpersonal, and clinic levels. The study will be conducted in four ART centers and involves both people living with HIV and healthcare workers. Participants will be involved in using the INCLUDE tool during clinic visits, providing feedback through surveys, interviews, and focus groups, and their app usage will be monitored. Researchers will measure acceptability ratings, assessment completion rates, application performance, and the implementation of stigma-reduction activities over a nine-month period. This pilot trial will gather comprehensive data to refine the tool and potentially support wider use to address intersectional stigma in HIV care.

Developing and Testing a Digital Health Tool for INterseCtional Stigma Assessment and Reduction at Multiple Levels and mUltiple DimEnsions (INCLUDE) to Improve HIV Care in ART Centers in Nepal