ORIGINAL ARTICLE Step UP! To Stamp Out Stigma: adapting and testing a bystander intervention to reduce HIV-related stigma Ann D. Bagchi 1 & Adam Thompson 2 & Kasny Damas 3 & Elise Corasim 1 Received: 7 December 2019 /Accepted: 1 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Aim HIV-related stigma is a traumatizing experience operating across socioecological levels. Few interventions have combined multiple methods of stigma reduction into a comprehensive approach. This study adapted bystander training to the context of HIV-related stigma and pilot tested the model. Subjects and methods The study drew upon the team’ s prior research to create an adapted bystander intervention. Thirty-nine participants met in three separate workshop sessions, which consisted of didactic training, group discussions, and contact between people living with HIV (PLHIV) and their friends/family members, and healthcare workers. Participants completed pre-/post-intervention questionnaires that included demographic characteristics and standardized measures of stigma and em- powerment. A person living openly with HIV served as the moderator. The study’ s principal investigator led a discussion to evaluate the workshop model. Results The workshops were associated with decreased feelings of powerlessness but did not show any immediate effects on feelings of stigmatization. Subjects unanimously recommended requiring the training for all healthcare providers. Conclusion The study showed the feasibility of adapting a bystander approach to HIV-related stigma. Interactive participation across different stakeholder groups allows for addressing various types of stigma and incorporating multiple evidence-based approaches to stigma reduction. Future research will incorporate further adaptations and test the approach using a large-scale randomized controlled trial. Keywords HIV . Stigma reduction . Bystander intervention . Empowerment Introduction Science has made significant strides in understanding the bi- ological mechanisms for the life cycle, transmissibility, and treatment of HIV. Despite this, stigma remains a significant factor undermining health outcomes along both the HIV pre- vention and care continua and status-neutral continuum (Fuster-Ruizdeapodaca et al. 2014; Golub and Gamarel 2013; Hatzenbuehler et al. 2013; Katz et al. 2013). With recent federal, state, and local initiatives to end the HIVepidemic in the United States, it is critical to first eliminate HIV-related stigma to ensure positive progress towards the end of the ep- idemic (McNairy and El-Sadr 2014; Mugavero et al. 2013; Myers et al. 2018). However, it has been difficult to develop comprehensive stigma-reduction interventions due to the complexity of the phenomenon. For example, multiple types of stigma have been identified (e.g., internal, enacted, antici- pated, etc.), stigma operates at various ecological levels (e.g., individual, interpersonal, structural), and stigma is contextu- ally and culturally specific (Stangl et al. 2019). Given this complexity, relatively few evidence-based HIV stigma- reduction interventions have been developed or widely tested. A recent review of research on HIV-related stigma inter- ventions identified 22 high-quality studies (including seven randomized controlled trials), with a wide range of designs, stigma targets, participants, and outcome measures (Reif et al. 2015). Given possible positive publication bias, it is not * Ann D. Bagchi abagchi@sn.rutgers.edu 1 School of Nursing, Rutgers, The State University of New Jersey, 366 Ackerson Hall, 180 University Avenue, Newark, NJ 07102, USA 2 Infectious Diseases, Jefferson Health New Jersey, Voorhees, NJ 08043, USA 3 School of Public Affairs and Administration, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA Journal of Public Health: From Theory to Practice https://doi.org/10.1007/s10389-020-01284-1