A cluster randomized trial of 'Teach HADITHI'teacher training intervention to reduce classroom HIV-related stigmain Kenya'

Abstract

The objective of this study is to evaluate an innovative film-based, curricular intervention to reduce H/A stigma in school contexts and thereby reduce H/A stigma learned, perceived or experienced by youth. We will assess whether the intervention reduces the H/A stigma in their teaching and classrooms as experienced by HIV-infectedyouth enrolled in AMPATH. Our primary endpoint will be decreased teacher self-reports of stigmatizing knowledge, attitudes, and beliefs (K/A/B) about HIV six months after undergoing the Teach HADITHI teacher training. Secondary endpoints include reported H/A stigma and clinical outcomes among HIV-infected youth whose teachers have or have not gone through the training. The central hypothesis is that that introducing culturally relevant media and interactions that increase knowledge about HIV, its treatment, and living with HIV, while also engaging empathy and emotional connections, will alter both teachers' K/A/B about HIV, as well as the H/A stigma within their classrooms hence creating an environment that supports positive living with HIV. The specific aims are: Aim 1: Assemble a multimedia teacher training module, focused on HIV and H/A stigma and adapted for maximum cultural relevance, curricular cohesion, and impact among Kenyan primary and secondary school teachers. Aim 2: Assess the impact of the Teach HADITHI intervention on Kenyan teachers' attitudes, beliefs, and knowledge about HIV and the level of HIV-related stigma among teachers. Exploratory Aim 3: Examine whether HIV-infected children and adolescentsin classrooms with teachers who have received the Teach HADITHI intervention report less perceived, enacted, or internalized stigma compared to those in classrooms with teachers who have not. We will take a phased approach to study activities. In Phase One (PHASE ONE: QUALITATIVE INQUIRY AND INTERVENTION DEVELOPMENT) we will conduct qualitative inquiry and intervention development to achieve Aim 1 to revise the HADITHI stigma module and materials. In Phase Two (PHASE TWO: RANDOMIZED TRIAL OF INTERVENTION), the 'Teach HADITHI'modular package developed in Aim 1, will be evaluated with a pre- and post-intervention design that compares teachers who complete the training with those at control schools in second sub-county who do not. Phase 2 will include testing the objectives of Aim 2 and the exploratory Aim 3.