# Adaptation and optimization of the Friendship Bench mental health intervention for adolescent girls and young women in South African PrEP delivery settings

> **NIH NIH R00** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $110,527

## Abstract

ABSTRACT
African adolescent girls and young women (AGYW) face high rates of HIV and common mental disorders. HIV
pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention approach which is being scaled up in South
Africa. However, symptoms of common mental disorders are significant barriers to PrEP use. Effective mental
health treatment, such as problem-solving therapy (PST), has the potential to be integrated with PrEP delivery
to address mental health challenges and modifiable barriers to PrEP use and improve PrEP adherence for
AGYW. The Friendship Bench is a promising evidence-based PST intervention option for AGYW in PrEP settings
given that it was developed for delivery in busy HIV clinics, is currently being scaled-up in South Africa, and
preliminary data suggests it can be adapted to improve HIV treatment adherence among African women.
Research is needed to evaluate its effectiveness on mental health and PrEP adherence outcomes and identify
implementation strategies for AGYW in PrEP delivery settings. In a prior K99 study (K99 MH123369), Dr. Velloza
and her team conducted human-centered design work to understand needs around integrated mental health and
PrEP intervention delivery and to adapt the Friendship Bench intervention and implementation strategies. The
overall goal of the current R00 study (R00 MH123369) is to test and optimize the adapted Friendship Bench for
African AGYW in PrEP delivery. The Specific Aims are to conduct a hybrid Type II implementation-effectiveness
trial to assess preliminary effectiveness of Youth Friendship Bench SA on PrEP adherence and mental health
while optimizing implementation for cost constraints in PrEP delivery (Aim 1) and identify themes around
intervention acceptability, appropriateness, and feasibility (Aim 2). In preparation for Aim 2 of this work, we
conducted a systematic review of acceptability metrics and met with key leaders in the HIV and implementation
science fields to discuss measurement approaches for these early implementation outcomes. We found
significant gaps in high quality acceptability, appropriateness, and feasibility metrics and a lack of standardization
in how these constructs are operationalized in HIV-related research specifically and the field of implementation
science more broadly. These gaps have prevented us from conducting Aim 2 data collection and analyses. This
12-month supplement application proposes to enhance the existing parent project by identifying and validating
acceptability, appropriateness, and feasibility metrics to inform Aim 2 of the parent study. We propose to leverage
our current R00 study to: 1) develop a toolkit of “best practice” acceptability, appropriateness, and feasibility
measures to inform Aim 2 of the parent R00 and harmonize implementation science efforts in the HIV prevention
field; and 2) validate acceptability, appropriateness, and feasibility measures in the context of our PrEP
implementation trial in Johannesburg. We are well-p...

## Key facts

- **NIH application ID:** 10818234
- **Project number:** 3R00MH123369-04S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Jennifer Velloza
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $110,527
- **Award type:** 3
- **Project period:** 2021-01-11 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10818234

## Citation

> US National Institutes of Health, RePORTER application 10818234, Adaptation and optimization of the Friendship Bench mental health intervention for adolescent girls and young women in South African PrEP delivery settings (3R00MH123369-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10818234. Licensed CC0.

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