# Structural and Social Transitions Among Adolescents in Rakai (SSTAR)

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2021 · $656,047

## Abstract

Project Abstract
 Adolescents in sub-Saharan Africa make the transition to adulthood facing considerable risk of
 HIV infection; this risk is particularly high for young women. Understanding social processes that
 produce HIV risk and protect young people is critical to developing the next generation of youth
 HIV prevention programs. Looking beyond individual characteristics and behaviors, social
 structural factors (socioeconomic status, educational opportunities, gender, AIDS orphanhood,
 public policies) and timing of adolescent and young adult social role transitions (leaving school,
 initiation of sexual behaviors, migration and leaving home, marriage formation and dissolution)
 are critical drivers of youth HIV acquisition and other reproductive outcomes. Yet, these findings
 raise new questions: how do the interrelationships among social transitions and the timing,
 ordering and tempo of these transitions influence HIV risk behaviors, and, ultimately, HIV
 infection? How do social structural factors influence HIV infection? How do social transitions
 mediate HIV risk? To answer these questions, new research is needed which applies innovative
 quantitative and qualitative methods to high quality longitudinal data. Over the past six years,
 the Rakai Youth Project has used new qualitative data and existing quantitative and longitudinal
 data from the Rakai Community Cohort Study (RCCS) to successfully define a continuum of
 social and proximate determinants for HIV acquisition among youth ages 15–24 from 1994–
 2013. Building on this work, Structural and Social Transitions among Adolescents and young
 adults in Rakai (SSTAR) will investigate the influence of social structural determinants on
 transitions from adolescence to adulthood using innovative statistical and qualitative research
 methodologies. SSTAR will define risk factors for and trends over time in key social transitions
 (sexual initiation, school leaving, marital formation and dissolution, migration, initiation of
 childbearing); interrelationships among transitions (ordering, timing, tempo); and consequences
 (HIV risk behaviors, acquisition) among adolescents and young adults using mixed methods.
 The proposed project will examine the influence on HIV acquisition of social structural
 determinants (access to schooling, SES, orphanhood, household structure, gender, government
 policy, HIV programs) directly and as mediated by social transitions, using the RCCS. Finally,
 SSTAR will explore the influence of social determinants and social transitions on HIV acquisition
 in: 1-high HIV incidence hotspot communities, 2- intermediate HIV incidence trading and
 transport hub communities, and 3- low HIV incidence settled, rural communities.

## Key facts

- **NIH application ID:** 10238089
- **Project number:** 5R01HD091003-05
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** JOHN S. SANTELLI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $656,047
- **Award type:** 5
- **Project period:** 2017-09-15 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10238089

## Citation

> US National Institutes of Health, RePORTER application 10238089, Structural and Social Transitions Among Adolescents in Rakai (SSTAR) (5R01HD091003-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10238089. Licensed CC0.

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