QI and Stigma Reduction

HIV-related stigma and discrimination (S&D) is a well-documented barrier to the successful scale-up of HIV services among persons living with HIV (PLWH) and key populations at high risk for HIV infection. Reducing HIV-related S&D in the healthcare setting therefore represents a key policy and implementation priority in global efforts to achieve UNAIDS' 90-90-90 targets by 2020.

Globally validated instruments for measuring HIV-related S&D in healthcare settings exist, yet their incorporation into national and subnational HIV programming is limited. Moreover, while routine measurement of HIV-related S&D is feasible, little work has been done to apply QI methods to the implementation of stigma reduction policies and interventions.

Applying QI to Stigma Reduction in Healthcare

The Southeast Asia Stigma Reduction QI Learning Network was launched in 2017 to accelerate incorporation of HIV-related S&D reduction activities in national and subnational HIV programs in Cambodia, Lao People's Democratic Republic, Thailand, and Vietnam. Key outcomes of Network activities include:

  • Measurement of HIV-related S&D among providers and PLWH in HIV treatment sites using validated survey tools
  • Application of quality improvement methods to the reduction of S&D
  • Inclusion of PLWH in implementation of S&D reduction activities
  • Sharing of implementation successes, effective interventions, and policy innovations among Ministries of Health in Southeast Asia


Implementation of Network activities is led by HEALTHQUAL and designed in partnership with Dr. Laura Nyblade and the Research Institute for Health Sciences, Chiang Mai University, and generous support through the US President's Emergency Plan for AIDS Relief (PEPFAR)

For more information on the Southeast Asia Stigma Reduction QI Learning Network, please contact Richard E. Birchard, MS, Deputy Director.


Bruce Agins, MD, MPH


Richard E. Birchard, MS

Deputy Director, HEALTHQUAL 


Laura Nyblade, PhD

Senior Technical Advisor, RTI International

Kriengkrai Srithanaviboonchai, MD, MPH

Associate Professor, Research Institute for Health Sciences

Chiang Mai University

Chanane Wanapirak, MD

Associate Professor, Research Institute for Health Sciences

Chiang Mai University

Jarun Chueayen

Data Manager, Research Institute for Health Sciences

Chiang Mai University