Fred Ssewamala, the William E. Gordon Distinguished Professor at the Brown School at Washington University in St. Louis, won a five-year $3.2 million grant from the National Institute of Mental Health, part of the National Institutes of Health (NIH), to lead a study looking at intervention strategies for HIV treatments among youth in Uganda.
The study is called Suubi+Adherence4Youth in Uganda. Ssewamala will analyze the Suubi (“hope” in the Luganda language) intervention using the Multi-Phase Optimization Strategy (MOST), a new methodological approach for building, optimizing and evaluating multicomponent interventions.
“If we want to improve the lives of adolescents living with HIV, this study will help us decide which intervention component or components are critical in achieving viral suppression in cost-effective ways among these youths,” Ssewamala said.
“The results of this study will not only advance intervention science for HIV care globally, but also build the evidence base for policymakers in resource-constraint settings for the best return on public health investment.”
Ssewamala will partner with researchers at the University of California, San Francisco.
The number of adolescents living with HIV in Uganda is more than 170,000 and growing. This study responds to calls for expanding differentiated care approaches for such adolescents and for new forms of HIV interventions by seeking to intervene in social and structural inequities that intensify the risk for high viral loads. Addressing these hardships can improve the livelihoods of such youths and give them the knowledge and resources to reliably manage their HIV care.
Suubi is an evidence-based combination intervention with four components: financial literacy training; incentivized matched youth savings accounts with income-generating activities; intervention for antiretroviral therapy adherence and stigma reduction; and engagement with role models living with HIV who share their lived experiences.
Suubi has shown robust effects on viral suppression and antiretroviral therapy adherence, mental health, psychosocial outcomes, family financial stability and family cohesion, Ssewamala said.
The study aims to understand which interventions most help in viral suppression, and their cost-effectiveness; and to determine factors that can improve or reduce HIV treatment adherence in adolescents living with HIV.