Development of HOPES Intervention for a Randomized Controlled Trial to Reduce the Perceived Stigma Among Women Living With HIV/AIDS in China

We developed and pilot-tested HOPES, the first theory-driven, culturally grounded mHealth program to reduce HIV-related stigma among Chinese women living with HIV/AIDS (WLWHA). Guided by the updated MRC framework, we synthesized a scoping review, 30 phenomenological interviews and multidisciplinary consultations, then co-created 12 weekly microdramas with 32 WLWHA from Yunnan/Henan that embed cultural motifs of face, family honor, and collectivism; content was delivered through an encrypted WeChat mini-program underpinned by narrative transportation and sexual script theories. In a two-stage, multicenter, prospective nonrandomized controlled pre-post clinical trial, participants demonstrated high engagement with the content. Qualitative feedback indicated strong cultural resonance and the acquisition of coping strategies. The intervention was associated with reductions in perceived stigma and improvements in coping self-efficacy, social support, and emotional well-being.