# Understanding the role of food insecurity and depression in non-adherence to Option B+ among perinatal Kenyan women living with HIV: a Syndemics approach

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $197,391

## Abstract

Project Summary/Abstract
Strategies to prevent mother-to-child transmission (PMTCT) of HIV can reduce the risk of vertical transmission
to less than 2%, but difficulties in adhering to the three pillars of PMTCT (maternal ART; exclusive
breastfeeding; provision of ART prophylaxis to infant; i.e., Option B+) has led to high rates of MTCT in sub-
Saharan Africa and suboptimal maternal and infant health. The goals of the proposed research are to 1) gain
an understanding of the influences and mechanisms by which food insecurity (FI) and perinatal depression-
two modifiable determinants of PMTCT Option B+ non-adherence-interact to impact Option B+ adherence and
2) refine our conceptual framework to aid in intervention development that assists mothers to maintain Option
B+ adherence. Candidate: I am a nurse-scientist with a background in health behavior change theory and
infant feeding in the context of HIV. I am applying for a K23 Career Development Award to obtain training,
mentorship, and research experience to become an expert and independent investigator in theory-based,
multi-level intervention design impacting maternal and infant health in the context of HIV in low-resource
settings. Mentoring: I have put together an exceptional mentoring team with extensive experience in HIV
treatment and prevention research in Kenya.
Drs. Sheri Weiser and Craig Cohen will serve as co-Primary
mentors and bring complementary expertise in HIV treatment and prevention, maternal and child health, FI,
conceptual framework refinement, and development and implementation of multi-level interventions in Kenya.
My co-mentors and scientific advisors round out my team to bring specific content and methods expertise and
are based both in the U.S and in Kenya, including: Dr. Mallory Johnson (clinical psychology, multi-level
intervention design and evaluation; feasibility implementation; ART adherence); Dr. Monica Gandhi (clinical
management of HIV, objective ART adherence); Dr. Elizabeth Bukusi (HIV in the Kenyan context, maternal
adherence), Dr. Sera Young (maternal and infant nutrition and FI, PMTCT considerations in intervention
design), and Dr. Tor Neilands (psychology, quantitative methods, design and analysis of longitudinal data).
Training: I propose to obtain training in FI, perinatal ART adherence, longitudinal quantitative study design and
analysis, and theory-based multi-level intervention development and evaluation. Training will be achieved
through mentor meetings, coursework, workshops, directed readings and primary research in Kenya.
Research: The goals of the proposed research are to 1) identify factors that increase risk for or protect against
FI and perinatal depression among HIV+ women during pregnancy and postpartum; 2) investigate the interplay
of FI and perinatal depression on adherence to PMTCT guidelines over time among an existing cohort of
perinatal women in Kenya;
3) develop a multi-level intervention and test feasibility with full scale testing in...

## Key facts

- **NIH application ID:** 10424410
- **Project number:** 5K23MH116807-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** emily tuthill
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $197,391
- **Award type:** 5
- **Project period:** 2018-06-18 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10424410

## Citation

> US National Institutes of Health, RePORTER application 10424410, Understanding the role of food insecurity and depression in non-adherence to Option B+ among perinatal Kenyan women living with HIV: a Syndemics approach (5K23MH116807-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10424410. Licensed CC0.

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