# Testing the effectiveness of an evidence-based transdiagnostic cognitive behavioral therapy approach for improving HIV treatment outcomes among violence-affected and virally unsuppressed women in SA

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $609,371

## Abstract

Project Summary
There are currently just under one million people with HIV in South Africa who have initiated antiretroviral
therapy (ART) but remain unsuppressed. South Africa has been making progress towards UNAIDS 90-90-90
targets but has only reached 47% of those infected being virally suppressed. Therefore, if effective approaches
can be found to keep patients on treatment, adhering, and virally suppressed, the impact could be significant.
In South Africa, one major barrier to consistent treatment is intimate partner violence (IPV) as nearly 50% of
women have experienced IPV. Addressing IPV could have effects in supporting patients on HIV treatment to
continue to adhere. The Common Elements Treatment Approach (CETA) is an evidence-based intervention
comprised of cognitive-behavioral therapy elements. It is transdiagnostic in that it can flexibly address a range
of problems and represents the current movement in global mental health as a more cost effective, scalable
and sustainable model. CETA is one of the most promising interventions to impact HIV outcomes through
addressing violence
 To evaluate CETA, we propose a randomized controlled trial of HIV-infected women, with or without
their partners, who have experienced IPV and have an unsuppressed viral load to test the effect of CETA on
increasing viral suppression and reducing violence. The study has three aims: Aim 1: Among HIV-infected
women on ART who have experienced IPV and have an unsuppressed viral load, to assess the effectiveness
of CETA vs. active control at increasing the proportion retained and virally suppressed by 12 months and at
decreasing the severity of IPV and other mental and behavioral health problems using an individually
randomized trial. Aim 2: To identify mediators and moderators of CETA’s effect on the primary outcome
(retention and viral suppression). Aim 3: To assess the cost and cost-effectiveness of CETA vs. active control
at increasing the proportion of women who have experienced IPV who are retained and virally suppressed by
12 months.
 The study question is significant given the prevalence of IPV in female patients with unsuppressed
viral loads in South Africa and the potential for improving viral suppression by addressing IPV and its sequelae.
If effective, this approach could have a significant global impact on outcomes for virally unsuppressed
women and reduce transmission to uninfected partners. It is innovative in utilizing an evidence-based
approach (CETA) shown to affect IPV as well as many other problems that contribute to poor HIV treatment
outcomes.

## Key facts

- **NIH application ID:** 10772003
- **Project number:** 5R01MH121998-05
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Matthew Alexander Pease Fox
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $609,371
- **Award type:** 5
- **Project period:** 2020-03-15 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10772003

## Citation

> US National Institutes of Health, RePORTER application 10772003, Testing the effectiveness of an evidence-based transdiagnostic cognitive behavioral therapy approach for improving HIV treatment outcomes among violence-affected and virally unsuppressed women in SA (5R01MH121998-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10772003. Licensed CC0.

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