KABAWIL: Reducing Intersectional Stigmas

NCT07786441 | Recruiting Phase 1

• 2 other identifiers: STUDY000208545R01TW012904
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to develop and test KABAWIL, a culturally tailored intervention designed to reduce HIV-related and intersectional stigmas experienced by Indigenous communities in Guatemala and improve engagement across the HIV Continuum of Care. The study will also assess the feasibility, acceptability, and implementation of the intervention. The main questions it aims to answer are: Can a culturally adapted version of the FRESH intervention reduce HIV-related and intersectional stigmas among Indigenous men and Indigenous healers? Does participation in KABAWIL improve outcomes related to HIV prevention, testing, treatment, and care using a status-neutral approach? Is KABAWIL feasible, acceptable, and appropriate for implementation in Indigenous communities in Guatemala? Researchers will first adapt the existing FRESH intervention through interviews and focus groups with Indigenous men, Indigenous healers, healthcare providers, stigma experts, and Maya knowledge keepers. Researchers will then compare participants who receive KABAWIL immediately with participants assigned to a 3-month wait-list control group. Participants will: Participate in interviews or focus groups to help adapt the intervention (Aim 1). Attend one of three KABAWIL workshops or be assigned to a 3-month wait-list control group (Aim 2). Complete surveys and assessments measuring HIV-related intersectional stigma and HIV Continuum of Care outcomes before and after the intervention (Aim 2). Participate in post-intervention interviews to provide feedback on the intervention's feasibility, acceptability, and implementation (Aim 3).

Conditions

Stigma, Social

Outcome Measures

Primary Outcomes (4)

• Study Feasibility

  Feasibility will be assessed by: Recruitment Rates: Track the number of eligible participants screened, approached, and successfully enrolled in the study. Retention and Attrition: Measure how many participants drop out or are lost to follow-up over time. Data Completeness: Assess how many outcome assessments or questionnaires have missing or invalid data point

  One-week and three-months after the intervention workshop is completed.

• HIV stigma among healthcare workers Scale

  This is a survey instrument designed to measure stigmatizing attitudes, beliefs, and behaviors toward people living with HIV among healthcare professionals. It is commonly used in research and program evaluation to assess the extent of HIV-related stigma within healthcare settings and to evaluate the effectiveness of stigma-reduction interventions.

  From enrollment to the end of the three-month follow-up.

• HIV Stigma Scale (Enacted Stigma, Disclosure Concerns, Negative Self-Image, & Concern w/ Public Attitudes)

  This is a self-report measure that assesses stigma experienced by people living with HIV across four key domains: Enacted Stigma: Experiences of discrimination, rejection, or unfair treatment due to HIV status; Disclosure Concerns: Worries about revealing one's HIV status and potential negative consequences of disclosure; Negative Self-Image: Internalized stigma, including feelings of shame, guilt, or lowered self-worth related to HIV infection; and, Concern with Public Attitudes: Perceptions of societal prejudice, stereotypes, and negative views toward people living with HIV.

  From enrollment to the three-month follow-up.

• Study Acceptability

  Will use a use Likert scale (1 to 5) survey to ask participants to rate their satisfaction, ease of use, and willingness to repeat the process.

  One-week and three-months after the intervention

Study Arms (2)

Immediate Intervention

EXPERIMENTAL

Participants will receive the intervention immediately.

Behavioral: Stigma Reduction Intervention

Wait-list

ACTIVE COMPARATOR

Participants will act as comparators and will receive the intervention three months later.

Behavioral: Stigma Reduction Intervention

Interventions

Stigma Reduction Intervention BEHAVIORAL

This a workshop-based intervention that has reduced HIV stigma among healthcare workers and gay, bisexual, and other men who have sex with men (GBM) in multiple countries. Guatemala's Indigenous population, which comprises nearly half of the country's residents, faces significant health inequities. Indigenous GBM experience intersecting forms of stigma related to HIV, sexual orientation, and Indigenous identity, increasing their vulnerability to poor HIV outcomes. The adapted intervention, KABAWIL, will be the first adaptation to include both Indigenous men and traditional healers. We will pilot test KABAWIL using a randomized wait-list controlled trial with 120 participants. Sixty participants (30 Indigenous GBM and 30 ITH) will receive the intervention through three workshops, while 60 participants will be assigned to a 3-month wait-list control group. The study will evaluate KABAWIL's preliminary efficacy, feasibility, acceptability, and implementation potential.

Immediate Intervention; Wait-list

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• year of age and older
• Self identifies as a man who has had sex with other men
• Self identifies as traditional healer

You may not qualify if:

• Requires working knowledge of Spanish
• Minor (under age 18)

Sponsors & Collaborators

• University of Washington: lead
• Fogarty International Center of the National Institute of Health: collaborator

Study Sites (1)

University of Washington

Seattle, Washington, 98105, United States

RECRUITING

MeSH Terms

Conditions

Social Stigma

Condition Hierarchy (Ancestors)

Social Behavior; Behavior

Study Officials

• Roberto Orellana, PhD

  University of Washington

  PRINCIPAL INVESTIGATOR

Central Study Contacts

E. Roberto Orellana, PhD

CONTACT

206-685-4771; popolvuh@uw.edu

Devon Bushnell

CONTACT

2065435524; devonb@uw.edu

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants do not know which arm they belong to.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, School of Social Work

Model Details: Wait-list control trial

Study Record Dates

• First Submitted: August 17, 2026
• First Posted: August 26, 2026
• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): March 31, 2027
• Study Completion (Estimated): March 31, 2027
• Last Updated: August 26, 2026

Record last verified: 2026-08

Locations

US (1)