# A total school approach using safeguarding to address HIV-related stigma and discrimination in boarding schools in Zambia

> **NIH NIH R01** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2024 · $185,040

## Abstract

PROJECT SUMMARY
HIV-related stigma and discrimination operate at multiple socioecological levels and are known obstacles to
optimal health and HIV outcomes. In Zambia, some boarding school environments can be characterized by a
culture of physical, verbal, and sexual abuse strongly linked to stigma and discrimination. Despite this, little
data exists on the impact of HIV-related stigma or stigma reduction interventions within school settings, with
even less attention to boarding schools. This study responds to the challenges of making Zambian boarding
schools safe, stigma-free havens with reduced risk behaviors and improved health outcomes for learners,
teachers, and support staff – both those living with HIV and those who are not. Building on evidence that
addressing HIV stigma and discrimination can disrupt the cycle of violence that is both cause and
consequence of HIV risk and vulnerability, this study’s objective is to pilot test and evaluate a ‘total school
approach’ to addressing HIV-related stigma and discrimination in boarding schools, embedded in a
safeguarding framework. We will co-create stigma reduction intervention packages with learners, teachers,
staff, people living with HIV and other key stakeholders at two boarding schools in Zambia. Learners, teachers,
and staff will be trained to then deliver trainings to at least 80% of each school’s population. For Aim 1, we will
conduct a formative phase to adapt a ‘total facility approach’ for addressing stigma and discrimination in
healthcare to the Zambian boarding school setting, and to co-create an intervention package, that uses a
safeguarding approach, with the participating school communities. For Aim 2, we will carry out a paired pre-
post study to pilot test the impact of the intervention on stigma and discrimination and broader safeguarding
measures. We will implement a pre-post study design with outcomes measured through repeat paired surveys
before and after the intervention. For Aim 3, a mixed-methods process evaluation will explore how the school
environment affects its population’s attitudes and behaviors and seek to understand implementation barriers
and facilitators with a view to informing sustainability and scale-up. The primary outcome measures will be self-
reported experience of abuse and stigmatizing attitudes relating to HIV. Mixed-methods approaches will
provide insight into why different elements of the intervention worked/did not work and maximize learning about
implementation of this approach to fostering a safe school environment, free from stigma and discrimination so
as to improve HIV-related outcomes.

## Key facts

- **NIH application ID:** 11002859
- **Project number:** 1R01TW012663-01A1
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Virginia Bond
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $185,040
- **Award type:** 1
- **Project period:** 2024-08-09 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11002859

## Citation

> US National Institutes of Health, RePORTER application 11002859, A total school approach using safeguarding to address HIV-related stigma and discrimination in boarding schools in Zambia (1R01TW012663-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/11002859. Licensed CC0.

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