Abstract
Adolescent girls and young women in Tanzania experience stigma related to sexual and reproductive health (SRH) and contraceptive use, which can discourage care-seeking and constrain reproductive autonomy. This mixed-methods pilot study assessed the feasibility, acceptability, and preliminary outcomes of participatory stigma-reduction workshops delivered in urban and rural Kilimanjaro, Tanzania. Data were collected between February 7 and March 7, 2025. Forty adolescent girls and young women aged 15 to 20 participated in a 3-day workshop series facilitated by trained local female facilitators. The workshops were adapted from an established stigma-reduction curriculum and used participatory dialogue, critical reflection on gender norms, and peer learning. Participants completed pre- and post-workshop surveys assessing contraceptive use stigma, broader adolescent SRH stigma, and sexual double standards. Focus group discussions with participants and facilitators explored workshop experiences, acceptability, and perceived impacts. All participants completed the workshops and surveys, and qualitative findings indicated that the participatory format was engaging and acceptable. Contraceptive Use Stigma scores decreased from pre- to post-workshop (p < .001; Cohen’s d = −0.76), whereas changes in broader adolescent SRH stigma and sexual double standards were not statistically significant. Qualitative findings suggested increased comfort discussing SRH, reduced moral judgment toward contraceptive use, and greater confidence communicating with peers and adults, while community- and provider-level barriers persisted. These pilot findings support the feasibility and acceptability of participatory stigma-reduction workshops and justify longer-term evaluation using a controlled design.
