KABAWIL: Reducing Intersectional Stigmas

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

Interventions

BEHAVIORAL

Stigma Reduction Intervention

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.

Sponsors & Collaborators

• Fogarty International Center of the National Institute of Health

  collaborator NIH

• University of Washington

  lead OTHER

Principal Investigators

• Roberto Orellana, PhD · University of Washington

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-09-01

Primary Completion

2027-03-31

Completion

2027-03-31

Countries

• United States

Study Locations