# Suubi4HER Round 2: Examining the Long-term Impact of A Combination Intervention on HIV Prevention, Care and Mental Health for Adolescents and Young Women in Uganda

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $679,273

## Abstract

PROJECT ABSTRACT. This competing renewal to Suubi4Her study (R01MH113486-Ssewamala, PI) will
examine the longitudinal impact of an evidence-based combination intervention combining economic
empowerment (EE) and family strengthening (FS) on HIV risk behaviors, cognitive, and mental health outcomes
among adolescent girls transitioning into young adulthood in poverty-impacted and HIV-burdened rural
communities in Uganda. Specifically, the study provides a unique opportunity to examine the longer-term effects
of an evidence-based combination intervention on HIV prevention (for adolescent girls who are HIV negative—
including PrEP use), and care and support continuum trajectories (of adolescent girls living with HIV – including
ART Adherence) during transition into young adulthood, a high-risk, yet understudied developmental stage in
sub-Saharan Africa (SSA). Adolescent girls and young women (AGYW) in SSA are still disproportionately
affected by high rates of HIV infection than their male counterparts. In 2022, 63% of all new HIV infections in
SSA were among women and girls. This increased risk of HIV infection among AGYW is exacerbated by poverty,
gender inequalities, stigma, discrimination, and disruptions to cognitive development trajectories that are
widespread across SSA. Yet, less than half (42%) of countries in SSA provide HIV prevention programs designed
specifically for AGYW. Alarmingly, communities with high HIV prevalence also report poor mental health,
including depression and suicidal ideation. This is particularly important during the transition from adolescence
to young adulthood as the brain is undergoing dramatic remodeling of dopaminergic neural networks. Adolescent
brain development enhances reward-seeking and peer influence, leading to risky decisions and mental health
issues without proper self-regulation, which improves in adulthood. Research indicates that poor mental health
during adolescence is more pronounced among girls than boys, underscoring the pressing need for girl-targeted
interventions during adolescence. The World Health Organization has recommended using multi-sectoral
approaches that address both structural and family-level issues. Approaches that concurrently address poverty
(e.g., via EE) and poor mental health (e.g., via FS) have a potential to concurrently reduce AGYW’s vulnerabilities
to HIV, and poor mental health and cognitive functioning. Our team recently concluded a 6-year (2017-2023, with
one-year no cost Extension), 3-arm cluster-randomized controlled trial, called Suubi4Her, that tested a
combination intervention guided by Asset Theory and family strengthening principles among 1260 school-going
adolescent girls aged 14-17 years at enrollment. In this competing renewal, we propose 3 aims: Aim 1: To
examine the long-term impact of the Suubi4Her intervention on young women’s HIV risk behaviors; Aim 2: To
elucidate the long-term effect of the Suubi4Her intervention on cognitive and mental health, and to ex...

## Key facts

- **NIH application ID:** 11019941
- **Project number:** 2R01MH113486-06
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Noeline Nakasujja
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $679,273
- **Award type:** 2
- **Project period:** 2017-08-01 → 2029-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11019941

## Citation

> US National Institutes of Health, RePORTER application 11019941, Suubi4HER Round 2: Examining the Long-term Impact of A Combination Intervention on HIV Prevention, Care and Mental Health for Adolescents and Young Women in Uganda (2R01MH113486-06). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/11019941. Licensed CC0.

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