# Reducing the intersecting stigmas of HIV, violence victimization, and mental health: a randomized controlled pilot integrating Project YES! Youth Engaging for Success and Problem Management Plus amon

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $228,881

## Abstract

PROJECT SUMMARY / ABSTRACT
Stigma is increasingly recognized as a modifiable factor impacting antiretroviral therapy adherence and viral
suppression among adolescents and young adults living with HIV (AYALHIV), however few interventions have
effectively reduced stigma or address intersectional stigma among this population. In this study we will address
internalized HIV stigma among AYALHIV, as well as internalized stigmas related to the prevalent youth
experiences of violence and depression. Further, we will also focus on intersectional stigma, capturing
anticipated stigma associated with the complex reality of AYALHIV’s multiple social identities. We will create an
intervention to reduce these multiple stigmas by building upon the evidence-based intervention Project YES!
Youth Engaging for Success. Project YES! is a peer mentoring program that effectively reduced HIV-internalized
stigma among 15-to 24-year old AYALHIV in Zambia, and among a subset of pediatric clinic participants,
increased their viral suppression. Project YES! data also highlighted critical intervention gaps, including high
levels of physical, sexual and/or emotional violence victimization among AYALHIV, and how participants who
screened positive for depression had lower levels of viral suppression. This data aligns with a growing body of
evidence linking violence victimization and depression with internalized stigma and viral failure. Project YES!
peer mentors would refer participants with violence experiences or depression and anxiety to the clinic health
staff in a system that provides minimal mental health training or services for AYALHIV. This research seeks to
address this gap by integrating the stigma reducing EBI youth peer mentoring program (Project YES!) with the
World Health Organization endorsed and proven mental health approaches that reduce symptoms of depression
and anxiety (Problem Management Plus (PM+) and Early Adolescent Skills for Emotions (EASE)) that are
delivered by lay health workers. By adapting and integrating PM+/EASE to create Project YES+, we will
specifically provide AYALHIV with problem-management skills that we hypothesize will interrupt the bi-directional
pathways among violence victimization, depression and internalized and intersectional stigmas. We will also
refine our measures of internalized stigmas related to violence and depression, and intersectional stigma.
Specific study aims include:
AIM 1: Adapt and integrate the WHO problem management-based PM+/EASE approaches for AYA (15-24
years) to create Project YES+ for implementation by lay youth mentors to improve viral status by reducing the
internalized and intersectional stigmas related to HIV, violence, and depression.
Aim 2: Use cognitive interviewing to adapt scales of violence- and depression-related internalized stigma and
intersectional stigma to improve stigma measurement among AYAHLIHV.
Aim 3: Assess the feasibility and acceptability of a Project YES+ intersectional stigma reductio...

## Key facts

- **NIH application ID:** 10542948
- **Project number:** 1R01TW012411-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Julie Anne Denison
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $228,881
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10542948

## Citation

> US National Institutes of Health, RePORTER application 10542948, Reducing the intersecting stigmas of HIV, violence victimization, and mental health: a randomized controlled pilot integrating Project YES! Youth Engaging for Success and Problem Management Plus amon (1R01TW012411-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10542948. Licensed CC0.

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