# Acceptability of an Internalized Stigma Reduction Intervention among Women Living with HIV in Tanzania

> **NIH NIH R21** · DUKE UNIVERSITY · 2020 · $176,023

## Abstract

ABSTRACT/PROJECT SUMMARY
The stigma associated with HIV, especially internalized stigma, yields a number of negative outcomes
including non-adherence to antiretroviral therapy, non-engagement in care, poor self-efficacy for
disclosure, and a diminished quality of life. Unfortunately, stigma is virtually synonymous with the
experience of being a woman living with HIV in Tanzania, East Africa, and around the world. In Tanzania,
despite the negative impact of stigma on HIV outcomes, interventions to mitigate the negative effects
of internalized stigma associated with HIV, and instruments to measure intervention efficacy, are
limited and critically needed. In Tanzania, the site for this study, approximately 810,000 women are living
with HIV. Through development and rigorous testing of theoretically grounded, culturally sensitive, linguistically
relevant, gender-specific internalized stigma reduction interventions, it is possible to help women
successfully self-manage internalized stigma so they can achieve a variety of beneficial psychosocial,
behavioral, and clinical outcomes including engaging in care, adhering to ART leading to an improved CD4+
T-cell counts and virologic suppression, and having an optimized quality of life. The internalized stigma
reduction intervention to be evaluated for adaptation in this study, Maybe Someday: the Voices of Women
Living with HIV, was identified to be effective in reducing internalized stigma among WLWH in the Southern
USA. The Maybe Someday intervention, designed to work through the theory of narrative transportation, uses
stories to help women understand elements of their own lives. In societies like Tanzania, where storytelling is
an important part of the oral literature and culture, the use of stories can be used to help individuals
acknowledge and reflect upon new truths in relation to self and their world producing transformations and
insights that endure. Thus, the specific aims for this proposed study are to:
 Aim 1: assess the acceptability, and areas of necessary adaptation, of the internalized stigma reduction
intervention, Maybe Someday, designed to mitigate the negative effects of internalized HIV- related stigma
among women living with HIV in Tanzania;
Aim 2: identify the preferred mode of intervention delivery among women living with HIV in Tanzania;
Aim 3: evaluate the cultural and linguistic sensitivity and psychometric properties of a set of adapted
measurement instruments essential to determining the efficacy of the Maybe Someday internalized stigma
reduction intervention to be adapted for WLWH in Tanzania.

## Key facts

- **NIH application ID:** 9914141
- **Project number:** 5R21TW011247-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Laura Nyblade
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $176,023
- **Award type:** 5
- **Project period:** 2019-04-15 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9914141

## Citation

> US National Institutes of Health, RePORTER application 9914141, Acceptability of an Internalized Stigma Reduction Intervention among Women Living with HIV in Tanzania (5R21TW011247-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9914141. Licensed CC0.

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