# Suubi4Her: A Combination Intervention Addressing HIV Risk Behaviors Among Older Adolescent Girls Transitioning into Adulthood in Uganda

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2020 · $907,118

## Abstract

Aligned with the NIH priority of addressing disparities in new HIV infections and the UNAIDS call for
implementing combination HIV prevention approaches, the proposed study will examine the impact and cost
associated with Suubi4Her, an innovative combination intervention that aims to prevent
HIV risk behaviors
among 15-17 year-old girls living in communities heavily affected by poverty and HIV/AIDS in Uganda. In sub-
Saharan Africa (SSA), family financial stress can compromise the support available to adolescents, with girls
living in poverty exhibiting higher rates of risky sexual behavior increasing their vulnerability in acquiring HIV
and other STIs. At the same time, internalizing mental health disorders such as depression and low self-
esteem disproportionately affect girls and may be contributing to HIV risk behavior. Against that backdrop,
support over and above health and sex education is needed to help adolescent girls in SSA successfully
transition into young adulthood. The proposed study is informed by two previously tested interventions – asset-
based matched savings accounts (YDA) and family strengthening through Multiple Family Groups (MFG)
which have successfully been implemented with younger primary school-going adolescents. Suubi4Her will
test the theory that youth cognitive and behavioral change is influenced by economic stability
while examining
if enhanced intra-familial support and communication are needed to maintain positive behavioral health
functioning and reinforce engagement in protective health behaviors. Nested within 42 secondary schools
across four districts of Uganda heavily impacted by HIV/AIDS, 1260 older girls (ages 15-17 at enrollment) will
be randomly assigned (at school level) to one of three study conditions: 1) Savings (Youth Development
Accounts - YDA)- with a 1:1 incentive match rate – for education and microenterprise development; 2) Savings
(YDA) + MFG intervention; 3) Control condition receiving standard health and sex education provided in
schools. The intervention will be provided for 24 months. Assessments at baseline,12, 24, and 36-months will
include biomedical data to measure our primary sexual-risk outcome:1) proportion of girls' biologically
confirmed STIs (Gonorrhea, Trichomonas and Chlamydia); and secondary outcomes: 2) the proportion of new
HIV infections during the study period, and 3) for HIV+ girls, viral load and CD4 as markers of ART adherence.
The study aims are to: 1) Examine whether the Suubi4Her intervention is effective in protecting adolescent
girls against known HIV risk factors (including economically-motivated sex and intimate partner violence). 2)
Elucidate the effects of the Suubi4Her intervention on behavioral health functioning (i.e., depression, self-
efficacy and hopelessness) and examine the effects of these variables as potential mechanisms of change,
mediating the relationship between each intervention and HIV risk reduction. 3) Evaluate the cost-effectiveness
of each ...

## Key facts

- **NIH application ID:** 9933088
- **Project number:** 5R01MH113486-04
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** FRED M SSEWAMALA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $907,118
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9933088

## Citation

> US National Institutes of Health, RePORTER application 9933088, Suubi4Her: A Combination Intervention Addressing HIV Risk Behaviors Among Older Adolescent Girls Transitioning into Adulthood in Uganda (5R01MH113486-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9933088. Licensed CC0.

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