Table 2.
Intervention and stigma summary
| Name | Intervention content | Primary outcomes | Population | Stigma type | Stigma level | Approach |
|---|---|---|---|---|---|---|
| Individual-level interventions | ||||||
| Healthy Choices [30] | Motivational interviewing intervention for HIV-positive youth and health care providers | Receptive anal sex, drug use for sexual pleasure, and STIs | Gay and bisexual men | HIV stigma | Internalized, anticipated | Mediator |
| SOLVE [53] | Online intervention targeting sexual shame and risky sexual behaviors | Condomless anal sex, shame | Young MSM | Shame | Internalized | Outcome; mediator |
| ESTEEM [36, 37] | In-person intervention using cognitive-behavioral skills to help participants directly address minority stress | Depression, anxiety, condomless sex, alcohol use, stigma coping | Gay, bisexual, and queer men | Explicit and implicit internalized homophobia, concealment | Internalized, anticipated | Outcome; moderator |
| RISE [27] | Web-based modules about social and cognitive aspects of internalized binegativity and attitudinal change. | Internalized binegativity | Bisexual individuals | Internalized binegativity, concealment | Internalized, anticipated | Outcome |
| ART adherence reminders [28] | Two-way SMS reminder messages for medication adherence | ART adherence | Men living with HIV | HIV stigma and discrimination | Enacted | Outcome |
| Expressive writing [35] | Brief expressive writing exercises about gay-related trauma or stress | Affect, gay-specific functioning and stress | Gay men | Gay-related rejection sensitivity | Anticipated | Outcome |
| Evaluative conditioning [58] | Internet-based intervention targeting self-esteem and self-efficacy to decrease homonegativity internalization | Internalized homophobia; self-esteem | Gay men | Internalized homophobic stigma | Internalized | Outcome |
| CBT skills intervention [29] | CBT intervention for HIV-related distress and mental health and for integration in health care settings | Depressive thoughts, anxiety, and HIV-stigma distress | MSM | HIV stigma | Internalized | Outcome |
| Latinos Empowering Ourselves [44] | Intervention to prevent HIV transmission by improving self-efficacy and self-empowerment | Condomless sex; condom self-efficacy | Latino gay and bisexual men | Sexual minority stigma, internalized homophobia | Enacted, anticipated, internalized | Content only |
| PrEPTECH [51] | Telemedicine, home PrEP delivery, and at-home STI testing; intervention targeting barriers to PrEP uptake and adherence | PrEP initiation; daily adherence | Young MSM of color | PrEP stigma | Anticipated | Content only |
| Healthy Relationships [31] | Intervention delivered in primary care settings that targeted coping skills to promote HIV-related health | Condom use; depression, anxiety, substance use, HIV status disclosure | Gay men | HIV stigma, mental health stigma | Internalized | Content only |
| Rainbow SPARX [34] | Computerized CBT video game addressing emotion regulation in response to stigma | Depressive symptoms | Sexual minority youth | Internalized homophobia, heterosexism, rejection, bullying | Internalized, anticipated, enacted | Content only |
| Group-level interventions | ||||||
| Somatic Experiencing [14] | Intervention targeting coping with gender minority stigma and gender dysphoria to improve mental health | Depression, anxiety, somatic symptoms, quality of life, coping with discrimination | Gender minorities | Gender minority stigma | Enacted | Moderator |
| 2GETHER [23] | Individual and group-based couples intervention to improve relationship functioning and sexual health | Sexual risk behavior, HIV prevention behaviors | Sexual minority men | Internalized homonegativity | Internalized | Moderator |
| Project PRIDE [17] | Intervention focused on coping in response to minority stress, substance use reduction, and mental health concerns | Mental health, internalized homonegativity, substance use, sexual risk, self-esteem | Sexual minority young men | Internalized homonegativity, concealment | Internalized, anticipated | Outcome |
| La Familia [18] | Group discussions focused on sexual orientation disclosure, family rejection, and oppression of immigrant, Latino MSM | Condom use and intentions, sex and substance use coping | Latino MSM | Internalized homophobia, disclosure discomfort | Internalized, anticipated | Outcome |
| Modified Group CBT [19] | Manualized CBT intervention for depression | Internalized and anticipated stigma, depression | Sexual minorities | Internalized homophobia | Internalized | Outcome |
| Queer Women Conversations [20] | Group psychoeducational sessions with content on personal goal setting, coping, sex and bodies, sexual and internalized stigma, and relationships | Sexual risk behavior, sexual stigma | Sexual minority women | Sexual stigma, internalized homophobia | Internalized, enacted, structural | Outcome |
| Life Skills for Men—Adaptation [16] | Peer-led group intervention focused on HIV risk including adapted topics (e.g., identity affirmation; communication and partner negotiation; coming out; sexual practices; and HIV) | HIV risk and sexual behaviors | Transgender MSM | Internalized homophobia, prejudice, cisgender male stigma | Internalized, enacted | Outcome |
| Health Mpowerment [21, 22] | Mobile web-based intervention to reduce logistical, financial, and stigma barriers to HIV prevention and care with support through online forums and support | Barriers to HIV prevention and care, stigma coping | Black MSM | HIV stigma, internalized homophobia, sexual prejudice | Internalized, enacted | Outcome |
| Acceptance and compassion-based group therapy [32] | Group psychotherapeutic intervention targeting the mental distress associated with internalized HIV stigma | HIV stigma, cognitive flexibility | MSM | HIV stigma | Internalized | Outcome |
| Web-based peer counseling [40] | A video-interactive, internet-based peer counseling intervention for an at-home HIV-testing program | Transportation and anticipated HIV stigma as barriers to HIV testing | Gay and bisexual men | HIV stigma | Anticipated | Outcome |
| All Gender Health [50] | Group prevention and sexual health education program using lectures, video, music, and discussion developed for transgender and gender-nonconforming populations | Safe sex self-efficacy, condom use and attitudes, number of casual partners, relationship monogamy | SGM | Gender minority stigma, transphobic discrimination | Enacted | Content only |
| AFFIRM [15] | Group CBT intervention with integrated sexual and gender affirming practice to improve coping and mental health | Depression and reflective stigma coping skills | SGM youth | Transphobic stigma | Enacted | Content only |
| TIM Project: A Black Young Men’s Health Study [45] | Facebook group intervention with videos and chats to improve HIV testing through HIV education, social support, and self-management | HIV testing | Black young MSM | HIV stigma | Enacted | Content only |
| Still Climbin’ [41] | Group CBT intervention targeting coping with minority stress across multiple stigmatized identities | Coping with discrimination | Black MSM | HIV, race, sexual orientation discrimination | Enacted | Content only |
| SSSR Program [24, 26] | Group-based couples intervention on relationship skills for same-sex male couples (e.g., communication; problem-solving; negotiating monogamy; and minority stress coping) | Relationship communication and satisfaction, minority stress coping | Sexual minority men | Homophobia | Internalized, enacted, structural | Content only |
| SSSR—female adaptation [25] | Group intervention focused on relationship education skills for same-sex female couples; adapted SSSR with female same-sex couple content | Relationship functioning, minority stress coping | Sexual minority women | Homophobia | Internalized, enacted, structural | Content only |
| Community-level interventions | ||||||
| POSSE [46] | Popular opinion leaders delivered intervention sessions with HIV risk reduction messages to young people in the House and Ball community | Sexual risk behavior, HIV stigma | Black young MSM and transwomen | HIV stigma | Enacted | Outcome |
| Out in Schools [42] | Film screenings in schools followed by facilitated dialogue about SGM experiences; both sexual minority and nonminority students participated | Suicide ideation, bullying discrimination, and school connectedness | Heterosexual and sexual minority youth | Discrimination, bullying | Enacted | Outcome |
| hivstigma.com [47] | Media campaign followed by moderated online blogs and forums aimed at reducing HIV stigma | HIV stigma | Sexual minority men | HIV stigma | Enacted | Outcome |
| Connect-To-Protect [33] | Community resource changes to decrease HIV stigma via community partner mobilization, targeting MSM, injection drug users, or heterosexual women | HIV stigma, HIV-related community resources | Young MSM, drug users, heterosexual women | HIV stigma | Internalized | Outcome |
| Combination Prevention Programme [39] | Multisite, multicity behavioral, biomedical, and structural interventions targeting HIV transmission and stigma in Mexico | Condom usage, HIV testing, awareness of HIV status, perceived stigma | MSM | HIV stigma, healthcare discrimination | Anticipated | Content only |
| Multilevel interventions | ||||||
| Life Skills [48] | Peer-led groups and individual intervention focused on HIV risk with transgender-specific topics (e.g., transgender pride, medical care, housing, and employment; sexual negotiation) | HIV risk reduction | Transwomen | HIV stigma, gay-related stress | Enacted | Outcome |
| Health Mpowerment—community adaptation [43] | Community-level intervention using peer outreach and small group to discuss HIV testing and safer sex topics | HIV testing, safe sex | Black MSM and transwomen | Racism, homophobia, comfort with being gay | Enacted, internalized | Outcome |
| Reducing stigma and increasing health [52] | Multitiered community intervention aimed at mitigating healthcare stigma as a barrier to HIV prevention | Stigma mitigation | MSM and female sex workers | Health care discrimination | Enacted, anticipated | Outcome |
| LA-ICCSSCH [49] | Individual and structural interventions targeting housing discrimination and HIV stigma to reduce HIV transmission | HIV stigma as barrier to HIV care, HIV education and prevention | Black MSM and people living with HIV | Housing discrimination, HIV stigma | Enacted | Outcome |
CBT cognitive behavioral therapy; MSM men who have sex with men; SGM sexual and gender minority.