# Making universal, free-of-charge antiretroviral therapy work for sexual and gender minority youth in Brazil

> **NIH NIH R34** · BROWN UNIVERSITY · 2022 · $201,798

## Abstract

Background. Sexual and gender minority (SGM) youth account for the largest number of incident HIV
infections in Brazil. Although HIV can be managed with ongoing antiretroviral therapy (ART), exceptionally high
levels of adherence are required. Brazil has implemented a comprehensive HIV treatment program with broad
access to ART, but this program does not specifically address barriers to optimal ART adherence, particularly
for SGM youth who experience many challenges taking their medication as prescribed. Overview. This
application seeks to develop and pilot test a theory-based, integrated technology and counseling intervention
to improve ART adherence among HIV infected SGM youth (ages 15-24) in Rio de Janeiro, Brazil. The
intervention aims to improve social support, self-efficacy for taking ART, and teach skills for problem-solving
barriers to promote better adherence. To inform the content, structure, and format of the proposed intervention,
the MPIs recently conducted focus groups with SGM youth (N = 18) and key informant interviews (N = 7) with
medical providers and staff at local HIV service organizations working closely with SGM youth in Rio de
Janeiro. Across focus groups and key informant interviews there was universal agreement that an intervention
should capitalize on and enhance social support structures among SGM youth, and address their specific
concerns, especially as related to the individual (e.g., ART side effects, mood, substance use), social (e.g.,
HIV/SGM stigma), and structural (e.g., clinic hours, transportation challenges) barriers that they regularly face.
Theoretical Model. The intervention is guided by Social Cognitive and Social Support Theories and is
grounded in the social and contextual realities of SGM youth living with HIV in Brazil. Specifically, social
support is emphasized and informational, problem-solving and cognitive-behavioral “steps” are addressed over
4-group adherence counseling sessions, which include short video vignettes that seek to normalize adherence
challenges. In addition, daily tailored SMS text messages are delivered as part of the intervention to facilitate
social-cognitive cues to take medications as prescribed. Research Plan. Phase 1: Refine and enhance
participant acceptability of the intervention and resolve any issues with intervention delivery/implementation;
this will be achieved by convening and obtaining feedback from our youth community advisory board
throughout this phase and subsequent phases; and by conducting an open-phase pilot with up to 12 SGM
youth, with post-intervention exit interviews, as well as obtaining feedback from our youth community advisory
board throughout this and subsequent phases. Phase 2: Examine, in a pilot randomized controlled trial, the
feasibility, acceptability and potential impact of the proposed intervention among 72 SGM youth who will be
equally randomized to the intervention or a time- and attention-matched control condition with standard of care.
Th...

## Key facts

- **NIH application ID:** 10396669
- **Project number:** 5R34MH126894-02
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Katie Brooks Biello
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $201,798
- **Award type:** 5
- **Project period:** 2021-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10396669

## Citation

> US National Institutes of Health, RePORTER application 10396669, Making universal, free-of-charge antiretroviral therapy work for sexual and gender minority youth in Brazil (5R34MH126894-02). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10396669. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*