# Suicide Assessment and Feasible Evidence-based Treatments for Youth Living with HIV: SAFETY Planning

> **NIH NIH R34** · UNIVERSITY OF PENNSYLVANIA · 2024 · $189,196

## Abstract

ABSTRACT
Estimates of suicidal ideation and behaviors (SIBs) amongst adolescents living with HIV (ALWH) in Sub-
Saharan Africa (SSA) range from 18-69%. Despite this significant burden, prevention efforts in the region are
lagging due to a myriad of structural and socio-cultural barriers. This need is particularly dire in Malawi, where
estimates of suicidal ideation amongst ALWH are high, mental health stigma is pervasive, suicide attempts are
criminalized, and psychiatric human resources are limited. Resource appropriate interventions that allow for
the identification, prevention, and management of SIBs amongst ALWH are urgently needed. The Friendship
Bench (FB) is an evidence-based counseling intervention designed to be delivered by trained, lay health
workers. The FB has proven highly effective for addressing common mood disorders such as depression,
which is major determinant of suicidality. Further, the FB has recently been adapted for ALWH in Malawi.
Enhancing FB with evidence-based suicide prevention activities, such as the Safety Planning (SP)
Intervention, may be a feasible and effective opportunity to meet the needs of ALWH with SIBs. SP aims to
reduce acute SIBs through the co-creation of coping strategies which can be utilized in the event of a suicidal
crisis to avert acute suicidal thoughts and manage suicidal urges. As few evidence-based suicide prevention
interventions have been implemented in Africa, SP is ideal for Malawi, given it has been delivered by non-
psychiatric specialists in the region, and can easily be incorporated into existing services to fully address
chronic SIBs. The long-term goal of our research program is to generate and implement an evidence-based
model to prevent suicide in Malawi amongst ALWH through increasing the capacity of the health system to
identify SIBs and provide evidence-based care as well as through enhancing the capacity of research and
policy makers to enact change. Our specific aims are: 1) to enhance the FB model with SP that is adapted to
meet the developmental and contextual needs of ALWH in Malawi through formative research; 2) evaluate the
feasibility, acceptability, fidelity, and preliminary efficacy of the enhanced FB+SP model through a pilot
randomized controlled trial; and 3) enhance capacity of mental health researchers and policy makers to
advocate for legislative change through symposiums, workshops and meetings for multisectoral collaboration.
The proposed aims pave the way for a R01 application to test the enhanced FB+SP intervention in a cluster
randomized controlled trial and represent an important step towards preventing suicide amongst ALWH in
SSA.

## Key facts

- **NIH application ID:** 10871958
- **Project number:** 1R34MH136204-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Kazione Kulisewa
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $189,196
- **Award type:** 1
- **Project period:** 2024-06-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10871958

## Citation

> US National Institutes of Health, RePORTER application 10871958, Suicide Assessment and Feasible Evidence-based Treatments for Youth Living with HIV: SAFETY Planning (1R34MH136204-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10871958. Licensed CC0.

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