Promoting Reductions in Intersectional StigMa (PRISM) - GHANA

2019-10-03 07:54:43 | BioPortfolio


The goal of this study is to determine the feasibility, acceptability and preliminary estimate of effect size of a multi-level intersectional stigma-reduction intervention on HIV testing among men who have sex with men (MSM) in Ghana through a time-compressed, budget-limited study. The eight-step ADAPT-ITT framework will guide our approach to enhancing the interventions' content to address intersectional stigma and combine the three separate interventions into one multi-level approach.


Three theory-based interventions will be combined that were previously implemented separately in Ghana for reducing stigma at Health Care Facility (HCF) level, increasing HIV testing at the peer group-level, and increasing peer social support at the individual-level. The Convergence Framework will be used for combining interventions. The ADAPT-ITT framework guides this approach to enhancing the interventions' content on intersectional stigma. To achieve these aims, a systematic adaptation is planned that will refine the individually developed HCF, peer- and individual-level interventions to produce a comprehensive multi-level intersectional stigma reduction intervention. This will consist of focus groups and in-depth interviews with HCF staff and men who have sex with men (MSM) to sharpen content on drivers and manifestations of HIV, same-sex and gender non-conforming stigmas within HCFs and peer groups and how these intersecting stigmas undermine HIV testing. This information will be used to refine the content of the interventions which will then be reviewed by a workgroup of HCF and Ghanaian MSM. The trial involves 8 HCFs, matched on HCF staff size. Matched pairs will each be randomized to have an intervention and a control arm. Before assignment to HCFs, 216 MSM, recruited through Starfish Sampling (combined time-location and peer-referral sampling), will be randomized to receive the intervention or usual care. Each arm of MSM will have members randomized to one of the four clinics per city and asked to stay in the assigned community-clinic pipeline.

The specific aims are:

1. To evaluate the feasibility and acceptability of a novel multi-component, multi-level intervention to address intersectional stigma.

2. To estimate the effect size of the intervention for scale up to a definitive efficacy trial.

Study Design




A multi-level stigma-reduction intervention


Not yet recruiting


Yale University

Results (where available)

View Results


Published on BioPortfolio: 2019-10-03T07:54:43-0400

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