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Table 4 Interventions used across conditions to address internalized, anticipated, or experienced stigma or disclosure concerns among persons with the condition

From: Out of the silos: identifying cross-cutting features of health-related stigma to advance measurement and intervention

Author Country Condition Target group N Evidence of effectiveness Comments
(Peer) counselling/education
Nuwaha et al. [115] Uganda HIV Adults in the community 1402 before; 1562 after The proportion of people who had ever tested for HIV increased from 18.6% to 62% (p < 0.001). Among people who had ever tested, the proportion who disclosed their HIV test result to a sexual partner increased from 41% to 57% (p < 0.001). The proportion who wanted the infection status of a family member not to be revealed decreased from 68% to 57% (p < 0.001) This concerned a home-based counselling and testing program
Jürgensen et al. [116] Zambia HIV Adult 16 and above 1500 pre
1107 post
There was an overall reduction of 7% in stigma from baseline to follow-up, mainly due to a reduction in individual stigmatizing attitudes but not in perceived stigma; the reduction did not differ between the trial arms (p = 0.423)
Being tested for HIV was associated with a reduction in stigma (p = 0.030) and HBVCT had a larger impact on stigma than other testing approaches (p = 0.080 vs. p = 0.551)
HBVCT trial
Conner et al. [117] USA Mental illness Older adults with depression in community 19 ISMI scores significantly reduced after participating in the 3-month peer educator intervention  
Lusli et al. [82] Indonesia Leprosy Persons affected by leprosy 67 clients; 57 controls Significant reduction was observed between the before and after total SARI Stigma scale scores (mean difference clients 9.6 vs. 5.6 for controls), Participation scale scores (mean difference clients 3.7 vs. 1.4 for controls) and WHOQOL-BREF scores (mean difference clients +6.5 vs. – 2.0 for controls) Outcome assessed on average 1–1.5 years after baseline
Skills building and empowerment
Cross & Choudhary [76] Nepal Leprosy Persons affected by leprosy 152 SHG participants and 102 controls Social participation in the intervention group (where participants were working as change agents) was much better than in the control group; the median scores on the Participation scale were 0 and 7, respectively (p < 0.0001, Kruskal–Wallis test)  
Bellamy & Mowbray [119] USA Mental health conditions Adults with mental illness 397 After a 6-month follow-up, those with greater participation showed greater quality of life, empowerment, school/vocational enrollment, and encouragement from mental health workers; a significant condition effect was found for empowerment (p < 0.01) and for school efficacy (p < 0.05); at 12-month follow-up, college or vocational enrollment had increased significantly  
Dalal [72] India Disabilities Persons with disabilities   The project resulted in four types of outcomes: (1) increased visibility and participation of people with disabilities in community activities; many of them stepped out of their houses for the first time; (2) the number of physically challenged attending meetings gradually increased from none to 30–40% during the 3 years; (3) there was almost a 150% increase in immunization against polio in the third year; (4) a greater number of people were reaching out to hospitals and rehabilitation centers in a nearby city; people who earlier thought that nothing could be done were now exploring the possibilities of medical rehabilitation with community support  
Uys et al. [71] Lesotho, Malawi, South Africa, Swaziland, Tanzania HIV Nurses
PLHA
41 PLHA
134 nurses
PLHA involved in the intervention teams reported less stigma and increased self-esteem Nurses in the intervention teams and those in the target group reported no reduction in stigma or increases in self-esteem and self-efficacy, but their HIV testing behavior increased significantly Pre- and post-test measured stigma, self-esteem and self-efficacy; the post-test was conducted within 1 month after the intervention
Dadun et al. [85]
Dadun et al. (submitted)
Indonesia Leprosy Persons affected by leprosy 20 qualitative + 30 quantitative In qualitative interviews, clients reported growing businesses, better self-esteem, improved interaction with neighbor and most also less stigma than before; in some cases, disclosure concern remained high; in the quantitative interviews, the mean difference between the pre- and post-assessment total score of the SARI Stigma scale for socioeconomic development clients and the control group was 10.0 vs. 6.7, for the Participation scale 3.6 vs. 1.4 and for the WHOQOL-BREF + 4.32 vs. – 2.00 Outcome assessed on average 1–1.5 years after baseline
  1. ISMI Internalized Stigma of Mental Illness, HBVCT home-based counselling and testing, PLHA people living with HIV and AIDS, SHG self-help group, WHOQOL-BREF WHO Quality of Life scale – Brief