Ines Aristegui

This session highlighted the role of stigma as fundamental determinant of health and discuss the need to move forward in implementing intervention to reduce stigma. Some examples of interventions design and implementation were presented, as well as option to study them through approaches such as implementation science.

Along the session it was discussed the need to acknowledge intersectionality of stigmas and to implement interventions in partnerships with the community. A Facility approach to stigma reduction implemented in Ghana, Tanzania and Thailand showed significant reductions in drivers and manifestations of stigma. It involves skills building and training staff and clients as facilitators, identifying champions from training and providing them with grants to develop their own intervention. Based on a study that found that women, more than men, increase the probability of having detectable viral load when more people knew their HIV status, the need to study the relationship between stigma and social ties. Social relationships are not necessarily supportive, especially for those who were not viral suppressed and adherence (low adherers). Implementation research was discussed as an adequate approach to guide the design, implementation, and data collection around interventions to reduce stigma.

There is a need to build on best practices, and scale up effective interventions, that are mostly small size. Adapting existing tools is a wisely manner to allocate limited resources. There are implementation research opportunities in scaling up interventions, cohort studies or economic evaluations .