Buddhist Understanding and Reduction of Myanmar Experiences of HIV Stigma and Exclusion

The protocol group was comprised of the participants who received the final, adapted study intervention over the course of 8 weeks. The intervention is modularized to eight weekly sessions of 2-hour group discussions. The facilitator applies the principle of Cognitive Behavior Therapy and provides psychoeducation to promote the awareness and understanding of HIV stigma as well as training to help participants acquire alternative coping skills, such as relaxation techniques. In five sessions, participants are introduced to the general cognitive-behavioral model of HIV stigma and are encouraged to track their thoughts, feelings, and behavioral responses when encountering external stigma or adverse events. The participants further learn to differentiate helpful and non-helpful coping strategies and practice applying helpful coping skills to effectively reduce their HIV stigma. In the other three sessions, participants further discuss more specific stigma that intersects with HIV stigma, including stigma in healthcare settings, access to social support, and available resources on the society levels. Stigma reduction: The intervention is modularized to have eight weekly sessions of 2-hour group discussions, led by a trained facilitator. The facilitator applies the principle of CBT and provides psychoeducation to promote the awareness and understanding of HIV stigma as well as training to help participants acquire alternative coping skills, such as relaxation techniques.

Interviews were conducted during the first phase of the study. With the goal of culturally adapting an existing intervention for use among people living with HIV from Myanmar, in-depth interviews were conducted with people living with HIV from Myanmar to explore and identify Buddhist conceptualizations of HIV stigma. Participants in the interview group were not followed for outcomes or AEs.

During the second step of the study, focus groups made up of Myanmar people living with HIV were presented the adapted intervention. Feasibility, acceptability, and appropriateness was assessed that informed the final version of the adapted study intervention for use in the target population. Participants in the focus group were not followed for outcomes or AEs.