1. We are the change: Self-stigma and HIV in Zimbabwe Deirdre Ní Cheallaigh

2. Vision and Goal Vision A Zimbabwean community of men and women living with HIV free of self- stigma Goal To empower and equip men and women living with HIV to tackle their self-stigma

3. Programme Model Phase I 2012-2013 Research Programme design and delivery Local adaptation, Advocacy Phase II 2014 Building Capacity for local facilitators Localising facilitators programme Advocacy Phase III 2015-2016 Research Local Programme delivery Zimbabwean Facilitators supported Advocacy

4. Phase I Formative research into core beliefs on self-stigma and HIV Published March 2015 http://www.smw.ch/content/smw-2015-14113/ Two local HIV positive women attended the School in Germany, 2013 Research tools to measure impact developed and ethics approval secured, 2013 Self-stigma and HIV course designed 12-week self-stigma and HIV course with two groups of 12 participants, September-November 2013 Curriculum revised based on delivery Research data analysed and will be published

5. The Methodology IBSR: The Work of Byron Katie

6. Course themes Session 0 Introduction to the Course Session 1 Introduction to The Work Session 2 What others think about me because I have HIV Session 3 How HIV limits me Section 4HIV treatment Session 5My HIV story Session 6Me, My Body and HIV Session 7My sex life since HIV Session 8 Shame and guilt Session 9Fears of disclosing my HIV status Session 10Death Session 11God and a friendly universe Session 12Who I truly am

7. Fears around disclosure

10. PARTICIPANTS 23 Participants Group A : 11 Women Group B : 6 Men, 6 Women Aged 25 to 54, half aged 41 or under Most (65%) had completed form 4 education Few working at baseline (5 women, 2 men) 11 women and 4 men married/living with stable partner All had children, most (17) had 2 to 4 children 21 were Shona, all were Christian

11. Measurements: Quality of Life (QoL), CES-D, Internalised AIDS Stigma Scale (IASS)

12. Quantitative results – 3 months

13. FEARS AROUND DISCLOSURE All of the time A lot of the time Some of the time A little of the time None of the time In the past 4 weeks, I haven't been able to live the way I'd like to because I'm so worried about my health In the past 4 weeks, I've been worried about my CD4 count In the past 4 weeks, I've been worried about my viral load In the past 4 weeks, I've been worried about when I'm going to die

14. RESULTS - FEARS AROUND DISCLOSURE

15. Fears around disclosure improved significantly following the intervention (P=0·023 comparing both follow-ups with baseline). There was no significant change between the 1-month and 3-month scores (P=0·329). So the improvement was immediate, but was maintained at 3 months The proportion who expressed no fears about disclosure rose from 35% at baseline to 61% at three-month follow-up.

16. GENERAL SUMMARY Most measures improved immediately More significantly, measures that improved maintained improvement at three months And some measures were improved at three months but not at one month No measure got worse

18. These themes emerged during pre-course focus group discussions of the question: “When you were first diagnosed with HIV, can you describe some of the feelings you had at the time? ” The size of each word roughly represents the number of times that the theme was mentioned by participants. Emerging themes (pre course)

19. These themes emerged from analysis of focus group discussions of the question: “If you had to describe what you got out of this course, what would you say?” The size of each word roughly represents the number of times that the theme was mentioned by participants. Emerging themes (post course)

20. www.trocaire.org Trócaire is the official overseas development agency of the Catholic Church in Ireland.