***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We developed a comprehensive and culturally applicable empowerment intervention social self-value package with an aim to assess its efficacy in order to improve the quality of life ( QoL ) of HIV infected people receiving antiretroviral treatment . Participants were r and omly allocated to receive either six weekly intervention sessions or st and ard care . Nonlinear mixed-effects models were performed to compare changes in empowerment scores over time . Between September and November 2014 , 1447 individuals were screened , of whom 132 were r and omly assigned to either the intervention or control group .  The mean scores of empowerment , social support and quality of life increased and stigma scores were reduced in the intervention group at 3- and 6-months . An intervention effect on social support , stigma and QoL was significantly increased by time and group with low and high empowerment . No adverse events were reported . The empowerment intervention was efficacious in improving QoL of HIV infected people . ResumenHemos desarrollado un fortalecimiento completo y cultural applicable a la intervención social del paquete del valor propio con la intención de evaluar su eficacia para mejorar la calidad de vida de las personas infectadas por el VIH que están recibiendo ART . A los participantes se les adjudicó aleatoriamente la asignación de seis dosis semanales o los cuidados est and ar . El result ado de los efectos se presentó para comparar los cambios en los valores del fortalecimiento a lo largo del tiempo . Entre septiembre y noviembre de 2014 , 1447 individuos fueron moritonizados , de los cuales 132 fueron aleatoriamente asignados para cada intervención o grupo de control . La media del valor del fortalecimiento , apoyo social y calidad de vida incrementaron y los valores del estigma fueron reducidos en la intervención grupal entre 3 y 6 meses . Los efectos de una intervención al apoyo social , estigma y calidad de vida se incrementaron significativamente en ese periodo y el grupo con un bajo y alto fortalecimiento . No hubo efectos secundarios notificados . La intervención en el fortalecimiento fue satisfactoria en la mejora de la calidad de vida de la gente infectada por el VIH HIV-related stigma among persons living with HIV/AIDS ( PLHIV ) is prevalent throughout sub-Saharan Africa . There is limited evidence , however , on which interventions are effective in reducing it . We used data from a prospect i ve impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Ug and a to examine the program impact on stigma . Stigma was measured using the comprehensive HASI-P scale , which demonstrated good internal consistency ( Cronbach ’s alpha = 0.87 ) and was correlated with several related constructs including physical and mental health-related quality of life , disclosure , and physical health symptoms in the sample . Using quasi-experimental difference-in-difference matching methods to better infer causality , we tested whether the intervention improved the overall stigma scale and its subscales . The food assistance intervention had a significant effect on reported internalized ( but not external ) stigma of approximately 0.2 SD ( p < 0.01 ) . The HASI-P stigma scale is a useful tool for measuring and tracking stigma .  Food assistance interventions , embedded in an HIV care program , can reduce internalized stigma This study sought to explore , describe and determine whether an HIV stigma-reduction community “ hub ” intervention would change the HIV stigma experiences of people living with HIV ( PLWH ) and the stigmatisation by the community in an urban area in South Africa . A convergent parallel mixed- method design with a single case pre-test post-test design and an interpretive description approach was utilised . The sample for this study included 62 PLWH recruited through accessibility sampling and 570 community members recruited through r and om voluntary sampling .  A sub- sample of both groups , selected using purposive voluntary sampling , was utilised for the in-depth interviews about stigma experiences of PLWH , and for perceptions and attitudes of the community toward PLWH . Both quantitative and qualitative data showed that stigma is present . Although no statistically significant changes were found , small practically significant changes were demonstrated in the experiences of PLWH and in the perceptions and attitudes of the community . The extent of changes was much more obvious in the responses of the PLWH and the community during their post-intervention qualitative interviews than the changes found with the quantitative measures . This study thus concludes that the HIV stigma-reduction community hub intervention was successful in initiating the onset of changes in a community through the PLWH and people living close to PLWH ( PLC ) as community mobilisers active in the community hub to mobilise their own communities towards HIV stigma reduction through social change The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women . Participants were expected to display increases in HIV disclosure , self-esteem , active coping and positive social support , and decreases in depression , avoidant coping , and negative social support .  Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006 . Using a quasi-experimental design , assessment s were conducted at baseline and two and eight months post-intervention . A series of r and om effects regression analyses were conducted , with the three assessment points treated as a r and om effect of time . At both follow-ups , the rate of disclosure in the intervention group was significantly higher than that of the comparison group ( p < 0.001 ) . Compared to the comparison group at the first follow-up , the intervention group displayed higher levels of active coping ( t = 2.68 , p < 0.05 ) and lower levels of avoidant coping ( t = −2.02 , p < 0.05 ) , and those who attended at least half of the intervention sessions exhibited improved self-esteem ( t = 2.11 , p < 0.05 ) . Group interventions tailored for newly HIV positive pregnant women , implemented in re source -limited setting s , may accelerate the process of adjusting to one 's HIV status , but may not have sustainable benefits over time Abstract Background We evaluate the impact of clinic-based PMTCT community support by trained lay health workers in addition to st and ard clinical care on PMTCT infant outcomes . Methods In a cluster r and omized controlled trial , twelve community health centers ( CHCs ) in Mpumalanga Province , South Africa , were r and omized to have pregnant women living with HIV receive either : a st and ard care ( SC ) condition plus time-equivalent attention-control on disease prevention ( SC ;  6 CHCs ; n = 357 ) , or an enhanced intervention ( EI ) condition of SC PMTCT plus the “ Protect Your Family ” intervention ( EI ; 6 CHCs ; n = 342 ) . HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions and those in the EI , four antenatal and two postnatal PMTCT plus “ Protect Your Family ” sessions led by trained lay health workers . Maternal PMTCT and HIV knowledge were assessed . Infant HIV status at 6 weeks postnatal was drawn from clinic PCR records ; at 12 months , HIV status was assessed by study administered DNA PCR . Maternal adherence was assessed by dried blood spot at 32 weeks , and infant adherence was assessed by maternal report at 6 weeks . The impact of the EI was ascertained on primary outcomes ( infant HIV status at 6 weeks and 12 months and ART adherence for mothers and infants ) , and secondary outcomes ( HIV and PMTCT knowledge and HIV transmission related behaviours ) . A series of logistic regression and latent growth curve models were developed to test the impact of the intervention on study outcomes . Results In all , 699 women living with HIV were recruited during pregnancy ( 8–24 weeks ) , and assessment s were completed at baseline , at 32 weeks pregnant ( 61.7 % ) , and at 6 weeks ( 47.6 % ) , 6 months ( 50.6 % ) and 12 months ( 59.5 % ) postnatally . Infants were tested for HIV at 6 weeks and 12 months , 73.5 % living infants were tested at 6 weeks and 56.7 % at 12 months . There were no significant differences between SC and EI on infant HIV status at 6 weeks and at 12 months , and no differences in maternal adherence at 32 weeks , reported infant adherence at 6 weeks , or PMTCT and HIV knowledge by study condition over time . Conclusion The enhanced intervention administered by trained lay health workers did not have any salutary impact on HIV infant status , ART adherence , HIV and PMTCT knowledge . Trial registration clinical trials.gov : number ABSTRACT The ANRS 12249 Treatment-as-Prevention ( TasP ) cluster-r and omized trial in rural South Africa uses a “ test and treat ” approach . Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial . A social science research agenda was nested within TasP with the aim of underst and ing the social , economic and context ual factors that affect individuals , households , communities and health systems with respect to TasP. Considering the rural nature of the trial setting , we sought to underst and community perceptions and experiences of the TasP Trial interventions as seen through the eyes of traditional health practitioners ( THPs ) . A qualitative study design was adopted using four repeat focus group discussion s conducted with nine THPs , combined with community walks and photo-voice techniques , over a period of 18 months . A descriptive , interpretive and explanatory approach to analysis was adopted . Findings indicate that THPs engaged with the  home-based testing services and  HIV  clinics established for TasP. Specifically , home-based testing services were perceived as relatively successful in increasing access to HIV testing . A major gap observed by THPs was linkage to HIV clinics . Most of their clients , and some of the THPs themselves , found it difficult to use HIV clinics due to fear of labelling , stigma and discrimination , and the ensuing personal implication s of unsolicited disclosure . On the one h and , a growing number of patients diagnosed with HIV have found sanctuary with THPs as alternatives to clinics . On the other h and , THPs in turn have been struggling to channel patients suspected of HIV into clinics through referrals . Therefore , acceptability of the TasP test and treat approach by THPs is a major boost to the intervention , but further success can be achieved through strengthened ties with communities to combat stigma and effectively link patients into HIV care , including partnerships with THPs themselves Introduction Injecting drug use is a primary driver of HIV epidemics in many countries . People who inject drugs ( PWID ) and are HIV infected are often doubly stigmatized and many encounter difficulties reducing risk behaviors . Prevention interventions for HIV-infected PWID that provide enhanced support at the individual , family , and community level to facilitate risk-reduction are needed . Methods 455 HIV-infected PWID and 355 of their HIV negative injecting network members living in 32 sub-districts in Thai Nguyen Province were enrolled . We conducted a two-stage r and omization : First , sub-districts were r and omized to either a community video screening and house-to-house visits or st and ard of care educational pamphlets . Second , within each sub-district , participants were r and omized to receive either enhanced individual level post-test counseling and group support sessions or st and ard of care HIV testing and counseling . This result ed in four arms : 1 ) st and ard of care ; 2 ) community level intervention ; 3 ) individual level intervention ; and 4 ) community plus individual intervention . Follow-up was conducted at 6 , 12 , 18 , and 24 months . Primary outcomes were self-reported HIV injecting and sexual risk behaviors . Secondary outcomes included HIV incidence among HIV negative network members . Results Fewer participants reported sharing injecting equipment and unprotected sex from baseline to 24 months in all arms ( 77 % to 4 % and 24 % to 5 % respectively ) . There were no significant differences at the 24-month visit among the 4 arms ( Wald = 3.40 ( 3 df ) ; p = 0.33 ; Wald = 6.73 ( 3 df ) ; p = 0.08 ) . There were a total of 4 HIV seroconversions over 24 months with no significant difference between intervention and control arms . Discussion Underst and ing the mechanisms through which all arms , particularly the control arm , demonstrated both low risk behaviors and low HIV incidence has important implication s for policy and prevention programming . Trial Registration Clinical Trials.gov Background Among people living with HIV ( PLHIV ) on antiretroviral therapy ( ART ) , it is important to determine how quality of life ( QOL ) may be improved and HIV-related stigma can be lessened over time . This study assessed the effect of peer support on QOL and internal stigma during the first year after initiating ART among a cohort of PLHIV in north-eastern Vietnam . Methods A sub- sample study of a r and omised controlled trial was implemented between October 2008 and November 2010 in Quang Ninh , Vietnam . In the intervention group , participants ( n = 119 ) received adherence support from trained peer supporters who visited participants ’ houses biweekly during the first two months , thereafter weekly . In the control group , participants ( n = 109 )  were treated according to st and ard guidelines , including adherence counselling , monthly health check and drug refills . Basic demographics were measured at baseline . QOL and internal stigma were measured using a Vietnamese version of the WHOQOL-HIVBREF and Internal AIDS-related Stigma Scale instruments at baseline and 12 months . T- 
    Output:
    
Conclusion Structural interventions such as scale-up of antiretroviral treatment , prevention of medication stockouts , social empowerment and economic strengthening may help substantially reduce self-stigma among individuals .