# Emotion regulation, ART adherence, and virologic status among adolescents and young adults living with HIV in Zambia

> **NIH NIH F31** · JOHNS HOPKINS UNIVERSITY · 2021 · $46,036

## Abstract

PROJECT SUMMARY/ABSTRACT
Background: Nearly two-thirds of adolescents and young adults living with HIV (AYALHIV) in Zambia have
virologic failure. To date, limited research has assessed the role of developmental factors in achieving positive
HIV self-management behaviors and favorable health outcomes among AYALHIV. A comprehensive
understanding of these factors is essential to respond to the HIV epidemic among this high-priority population.
Study Goal and Aims: Leveraging a parent study that tests the AYALHIV-caregiver Family Connections
intervention in Zambia, the proposed research will validate and assess a measure of adolescent development
– emotion regulation – in relation to virologic failure, ART adherence, and family and social factors. Specific
aims are: 1) Validate the Difficulties in Emotion Regulation Scale (DERS-SF) among AYALHIV in Zambia; 2)
Examine associations between emotion dysregulation and a) virologic failure and b) incomplete ART
adherence, assessing moderation and mediation by family and social factors; and 3) Use dyadic in-depth
interviews with AYALHIV and caregivers to explore relationships identified in Aim 2 between emotion
regulation and HIV self-management, and experiences with the Family Connections intervention, comparing
AYALHIV with and without emotion regulation difficulties.
Approach: Aims 1 and 2 of the proposed research will use secondary questionnaire data collected at baseline
by the parent study; Aim 2 also uses measures of virologic status (blood draw) and ART adherence (urine
point of care test). In Aim 1, a hierarchical confirmatory factor analysis will be used to validate the DERS-SF.
Aim 2 will use structural equation modeling (SEM) to assess relationships between the DERS-SF, virologic
status, and moderation and mediation by family and social factors; secondarily, a similar SEM be used to
assess relationships with ART adherence. Aim 3 involves primary qualitative data collection with AYALHIV/
caregiver dyads, and will use an inductive approach to gain a nuanced understanding of Aim 2 relationships
and AYALHIV's intervention experiences, comparing youth with and without emotion regulation difficulties.
Fellowship Information: The proposed research is the doctoral dissertation of Ms. Kathleen Ridgeway, a PhD
student at the Johns Hopkins Bloomberg School of Public Health. Ms. Ridgeway's research and training will be
supported by experts in adolescent HIV research, qualitative methods, and advanced statistical analysis and
includes one Sponsor, two co-Sponsors, and two Scientific Advisors. A combination of didactic coursework,
mentorship, independent study, and practical experience will further Ms. Ridgeway's career goal to become a
leading independent researcher in adolescent health and HIV. This proposal directly responds to the NIH
Program Announcement (PA-18-651) and Notice of Special Interest (NOT-MH-20-035) for developmentally
tailored HIV prevention and care research for adolescents and young adult...

## Key facts

- **NIH application ID:** 10326648
- **Project number:** 1F31MH128133-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Kathleen Marie Ridgeway
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $46,036
- **Award type:** 1
- **Project period:** 2021-08-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10326648

## Citation

> US National Institutes of Health, RePORTER application 10326648, Emotion regulation, ART adherence, and virologic status among adolescents and young adults living with HIV in Zambia (1F31MH128133-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10326648. Licensed CC0.

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