A Rapid Review of HIV-Related Stigma-Reduction Randomized Controlled Trials.

Abstract

We conducted a rapid review to identify and describe randomized controlled trials (RCTs) aimed at reducing HIV-related stigma. Using a rapid review design in accordance with PRISMA guidelines, we searched five major databases (PubMed, PsycINFO, OVID/Medline, EMBASE, and Scopus) from July 1981 to June 2023, and analyzed 27 studies from an initial pool of 2,383 articles. Our analysis revealed three primary intervention strategies: (1) alleviating internalized stigma through confidence-building and emotional validation, (2) addressing anticipated and enacted stigma via training and sensitization campaigns, and (3) challenging institutional and cultural beliefs through macro-scale interventions. Community-driven approaches and locally-engaged interventions demonstrated particular promise, especially in resource-constrained settings. While intrapersonal and interpersonal approaches-particularly those involving professional discussions, peer education, and in-person training-showed the most positive outcomes, digital and infotainment interventions yielded mixed results. Our findings highlight the complexity of HIV-related stigma, revealing the importance of holistic strategies that address intersecting psychosocial factors and potential unintended consequences of stigma-reduction efforts. By studying the nuanced landscape of stigma intervention, this review provides insights for developing more comprehensive and contextually sensitive approaches to reducing HIV-related stigma.