# HIV Engagement and Adolescent Depression Support (HEADS-UP)

> **NIH NIH R34** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $237,763

## Abstract

ABSTRACT
 Sub-Saharan Africa is home to the largest population of adolescents living with HIV
(ALWH). Engaging ALWH in HIV care is challenging and reflected in lower rates of viral
suppression and higher rates of loss to follow-up as compared to adults in the region. Depression
has been identified as a significant barrier to initiating and remaining in HIV care. Indeed, this is
the case for ALWH in Malawi where estimates of viral suppression range from 40%-78% and
estimates of depression range from 18-26%. Resource-appropriate interventions that improve
depression and address engagement in HIV care for ALWH are urgently needed.
 The Friendship Bench (FB) is an evidence-based depression counseling intervention
delivered by trained, supervised lay health workers. It is proven to reduce depression in the
general population in low-resource settings but has not been adapted to be youth-friendly or
enhanced with peer support to facilitate engagement in HIV care among ALWH. FB is based on
problem-solving therapy, which offers an ideal framework for youth-friendly adaption and
integration of retention peer support into a proven depression treatment model.
 Our long-term goal is to adapt, test, and scale up resource-appropriate interventions to
reduce depression and improve engagement in HIV care amongst ALWH. Our specific aims are:
1) to conduct formative research for youth-friendly adaptation and peer support enhancement of
FB; 2) to adapt the evidence-based FB protocol to meet the developmental and contextual needs
of ALWH and enhance this adapted FB protocol with peer support to facilitate HIV care
engagement among ALWH; and 3) to determine the feasibility, fidelity, and acceptability of the
Adapted and Enhanced FB protocols to improve depression and engagement in HIV care among
ALWH. For the latter, we will conduct a 3-arm individually randomized pilot study to compare the
adapted FB and the enhanced FB to standard care. The proposed aims pave the way for a R01
application to test the adapted and enhanced Friendship Bench interventions in a cluster
randomized controlled trial and represent an important step forward towards improving
depression among ALWH.

## Key facts

- **NIH application ID:** 10828328
- **Project number:** 5R34MH130232-03
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Nivedita L Bhushan
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $237,763
- **Award type:** 5
- **Project period:** 2022-04-15 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10828328

## Citation

> US National Institutes of Health, RePORTER application 10828328, HIV Engagement and Adolescent Depression Support (HEADS-UP) (5R34MH130232-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10828328. Licensed CC0.

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