HIV-Related Stigma Intervention for Malaysian Clinicians

NCT05597787 | Completed Results

• 1 other identifier: R34MH124390
• Study Type: interventional
• Target: 78
• Locations: 1 country
• Sites: 1

Brief Summary

Key populations at risk of HIV (including men who have sex with men, people who inject drugs, transgender women, and female sex workers) are more likely to be infected with HIV but less likely than members of the general population to know of their HIV status, receive HIV prevention counseling, or be linked to HIV care services. Clinician stigma towards these groups remains a potent and persistent driver of these HIV disparities in many places of the world. The investigators propose to incorporate evidence-based stigma reduction tools into a popular teletraining platform for clinicians and pilot test the resulting intervention (Project ECHO® for HIV Prevention and Stigma Reduction) with clinicians in Malaysia, a context wherein clinician stigma and HIV disparities are substantial.

Conditions

Hiv

Outcome Measures

Primary Outcomes (5)

• Acceptability of Intervention

  Measured with Acceptability of Intervention Measure. Theoretical or possible range of scores is 1-5, and actual range was 3.50-5. Higher scores indicate greater acceptability.

  Month 9 Assessment

• Feasibility of Intervention

  Measured with Feasibility of Intervention Measure. Theoretical or possible range of scores is 1-5, and actual range was 3.25-5. Higher scores indicate greater feasibility.

  Month 9 Assessment

• Stigma Reduction: Prejudice

  Measured with Feelings Thermometers. Positive/Negative affect is measured on 0-100 point scale, with higher scores indicating more prejudice.

  Month 9 Assessment

• Stigma Reduction: Stereotypes

  Measured with subscale of Multidimensional HIV-Related Stigma Scale. Theoretical or possible range of scores is 1-5, and actual range was 1-3.44. Higher scores indicate greater stereotypes.

  Month 9 Assessment

• Stigma Reduction: Discrimination

  Measured with subscale of Multidimensional HIV-Related Stigma Scale. Theoretical or possible range of scores is 1-5, and actual range was 1-5. Higher scores indicate greater discrimination.

  Month 9 Assessment

Secondary Outcomes (2)

• HIV Prevention Procedures: HIV Testing

  Cumulative over 9 month intervention

• HIV Prevention Procedures: PrEP Prescriptions

  Cumulative over 9 month intervention

Study Arms (3)

HIV Connect

ACTIVE COMPARATOR

Participants randomized to this condition will complete HIV Connect, which is an online course developed by the Malaysian Society of HIV Medicine designed to educate primary care physicians in Malaysia about HIV. It consists of a series of modules featuring HIV infectious disease experts who instruct on topics including epidemiology and natural history of HIV, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), sexual history taking and STI testing, and others.

Behavioral: HIV Connect

Project ECHO for HIV Prevention

ACTIVE COMPARATOR

Participants randomized to this condition will receive Project ECHO for HIV Prevention, without added evidence-based stigma reduction tools. Participants will meet with the Project ECHO Hub specialists and their learning community on a bi-weekly basis for 60 minutes over the course of 9 months. Each session will feature a didactic training incorporating standardized procedures for HIV testing, prevention, and/or linkage to care, and patient-case presentation and discussion.

Behavioral: Project ECHO for HIV Prevention

Project ECHO for HIV Prevention + Stigma Reduction

EXPERIMENTAL

Participants randomized to this condition will receive the Project ECHO for HIV Prevention intervention with added evidence-based stigma reduction tools. Participants will meet with the Project ECHO Hub specialists and their learning community on a bi-weekly basis for 60 minutes over the course of 9 months. Each session will feature a didactic training incorporating standardized procedures for HIV testing, prevention, and/or linkage to care, and patient-case presentation and discussion.

Behavioral: Project ECHO for HIV Prevention and Stigma Reduction

Interventions

HIV Connect BEHAVIORAL

online education and clinical skills

HIV Connect

Project ECHO for HIV Prevention BEHAVIORAL

education and clinical skills

Project ECHO for HIV Prevention

Project ECHO for HIV Prevention and Stigma Reduction BEHAVIORAL

education, clinical skills and contact

Project ECHO for HIV Prevention + Stigma Reduction

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• practicing general practitioner or family medicine specialist in Malaysia

Sponsors & Collaborators

• University of Delaware: lead
• University of Malaya: collaborator

Study Sites (1)

University of Malaya

Kuala Lumpur, Malaysia

Location

Related Publications (2)

• Earnshaw VA, Collier ZK, Wong PL, Saifi R, Chong N, Ng RX, Azwa I, Basri S, Hassan ABA, Mousavi M, Omar SFS, Walters S, Haddad MS, Kamarulzaman A, Altice FL. Pilot randomized controlled trial to reduce HIV-related stigma among clinicians in Malaysia via project ECHO(R). AIDS Care. 2025 Aug;37(8):1313-1331. doi: 10.1080/09540121.2025.2534539. Epub 2025 Jul 30.

  PMID: 40736373 DERIVED

• Chong N, Azwa I, Hassan AA, Mousavi M, Wong PL, Ng RX, Saifi R, Basri S, Omar SFS, Walters SM, Collier ZK, Haddad MS, Altice FL, Kamarulzaman A, Earnshaw VA. Strengthening HIV Activism Among Clinicians in Malaysia: A Randomised Controlled Trial. AIDS Behav. 2025 Dec;29(12):3931-3939. doi: 10.1007/s10461-025-04829-1. Epub 2025 Jul 21.

  PMID: 40691430 DERIVED

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV Infections; Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Slow Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases

Results Point of Contact

• Title: Valerie Earnshaw
• Organization: University of Delaware

earnshaw@udel.edu

(302) 831-6500

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 25, 2022
• First Posted: October 28, 2022
• Study Start: July 26, 2022
• Primary Completion: March 31, 2023
• Study Completion: May 11, 2023
• Last Updated: December 11, 2024
• Results First Posted: December 11, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will share

Locations

MY (1)