Study of a Stigma Reduction Program to Help Women With Serious Mental Illness and HIV Stay Healthy in Botswana

What this Trial Is About

Researchers are evaluating an intervention aimed at supporting women living with both serious mental illness SMI and HIV in Botswana. These women face challenges with stigma that affect their adherence to psychiatric and antiretroviral treatments, which can worsen their health outcomes. The study tests a culturally tailored stigma reduction program called What Matters Most WMM during the critical transition from psychiatric hospitalization to outpatient care. The study also includes family members and policymakers to address stigma on multiple levels and encourage structural change. The trial has two main groups one receiving the WMM-based stigma intervention and another receiving an attention control focusing on general health education without stigma content. Women participants will attend eight group sessions led by a clinician and a peer with lived experience, starting during inpatient care and continuing in community settings after discharge. Family members will receive a parallel stigma intervention with three group sessions. Policymaker workshops will share findings through peer co-leaders to promote broader policy changes. Participants will be followed for four months after intervention completion, with assessments including viral load measurements, psychiatric and antiretroviral treatment adherence, mental health status, and social integration outcomes. Researchers will monitor changes from baseline to evaluate the interventions impact on viral suppression and related health factors. The study also tracks family stigma as a mechanism for change and includes safety monitoring throughout the study period, which is expected to last approximately 16 months from baseline to final follow-up.

RCT of an Intersectional Stigma Intervention to Sustain Viral Suppression Among Women Living With Serious Mental Illness and HIV in Botswana