# Suubi-Mhealth: A mobile health intervention to address depression and  improve ART adherence among Youth living with HIV (YLHIV) in Uganda

> **NIH NIH R21** · WASHINGTON UNIVERSITY · 2022 · $194,064

## Abstract

PROJECT ABSTRACT
Approximately 1.7 million children under 15 years old were living with HIV in 2020; and most new HIV infections
(85%) occurred in Sub-Saharan Africa (SSA). People living with HIV (PLHIV) often struggle with mental health
comorbidities that lower their antiretroviral therapy (ART) adherence. However, 76% to 85% of PLHIV in SSA
receive no treatment for serious mental health disorders, especially depression. Depression reduces ART
adherence, which negatively impacts health and increases HIV transmission risks. Older adolescents (≥14 years)
living with HIV are particularly vulnerable to these risks as caregivers withdraw or lessen their support during
their transition to young adulthood. Moreover, older adolescents are also moving into larger and less
accommodating adult HIV clinic settings and are at risk for dropping out of ART programs. Given that mental
health services are severely under equipped in SSA, including in Uganda, and are inaccessible by many YLHIV,
new solutions to increase access to mental health care and close the treatment gap are urgently needed. The
overall goal of this proposed R21/33 study is to develop an mHealth intervention (Suubi-mhealth) for use among
Ugandan youth (14-17 years) with comorbid HIV and depression, taking into account their unique contextual,
cultural, and developmental needs. This digital therapy intervention delivered via a mobile application, will
utilize the core tenets of cognitive-behavioral therapy (CBT) found to improve depression and ART adherence.
The proposed study will specifically: Phase 1. R21 Aim 1: Develop and iteratively refine an intervention
protocol for Suubi-Mhealth based on formative work to understand needs of youth living with HIV (YLHIV). We
will conduct four focus groups with youth and two focus groups with health care providers (6-8 youth each) for
feedback on intervention content and methods to increase participation and retention. R21 Aim 2: Based on
results of Aim 1, explore the feasibility and acceptability
subsequent refinement for the larger R33 phase. Phase
of Suubi-Mhealth on a small scale (N=30), to inform
2. R33 Aim 1: Test the preliminary impact of Suubi-
Mhealth versus a waitlist control group (N=200), on youth outcomes (depression, ART adherence, mental health
functioning, quality of life, stigma). R33 Aim 2: Examine barriers and facilitators for integrating Suubi-Mhealth
into health care settings for YLHIV. The study will be conducted in 10 health clinics in the greater Masaka region
in Southern Uganda. We expect for Suubi-Mhealth to be an acceptable and feasible mHealth tool to reduce
depression, improve ART adherence and overall mental health functioning among YLHIV. If the results of this
pilot are promising, then the next step is an R01 to rigorously test Suubi-Mhealth in a larger trial, spanning
multiple sites across Uganda.

## Key facts

- **NIH application ID:** 10526768
- **Project number:** 1R21MH131044-01
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Patricia A Cavazos-Rehg
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $194,064
- **Award type:** 1
- **Project period:** 2022-09-08 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10526768

## Citation

> US National Institutes of Health, RePORTER application 10526768, Suubi-Mhealth: A mobile health intervention to address depression and  improve ART adherence among Youth living with HIV (YLHIV) in Uganda (1R21MH131044-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10526768. Licensed CC0.

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