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Feasibility and Acceptability of Group-Based Stigma Reduction Interventions for Adolescents Living with HIV and Their Caregivers: The Suubi4Stigma Randomized Clinical Trial (2020–2022)

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Abstract

This study examined the feasibility and acceptability of two group-based interventions: group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family group (MFG-FS), to address HIV stigma among adolescents living with HIV (ALHIV) and their caregivers. A total of 147 adolescent -caregiver dyads from 9 health clinics situated within 7 political districts in Uganda were screened for eligibility. Of these, 89 dyads met the inclusion criteria and provided consent to participate in the study. Participants were randomized, at the clinic level, to one of three study conditions: Usual care, G-CBT or MFG-FS. The interventions were delivered over a 3-month period. While both adolescents and their caregivers attended the MFG-FS sessions, G-CBT sessions were only attended by adolescents. Data were collected at baseline, 3 and 6-months post intervention initiation. The retention rate was 94% over the study period. Across groups, intervention session attendance ranged between 85 and 92%, for all sessions. Fidelity of the intervention was between 85 and 100%, and both children and caregivers rated highly their satisfaction with the intervention sessions. ALHIV in Uganda, and most of sub–Saharan Africa, are still underrepresented in stigma reduction interventions. The Suubi4Stigma study was feasible and acceptable to adolescents and their caregivers –supporting testing the efficacy of the interventions in a larger trial.

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Acknowledgements

We are grateful to the staff and the volunteer team at the International Center for Child Health and Development (ICHAD) in Uganda for monitoring the study implementation process. Our special thanks go to all the children and their caregiving families who agreed to participate in the study.

Funding

This work was supported by the National Institute of Mental Health (NIMH; Grant # R21MH121141, 2020–2022; MPIs: Proscovia Nabunya, PhD and Fred M. Ssewamala, PhD). NIMH had no role in the study design, data collection, analysis, interpretation of findings and preparing this manuscript. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH.

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Authors and Affiliations

  1. International Center for Child Health and Development (ICHAD), Brown School Washington University in St. Louis, One Brookings Drive, Box 1196, St. Louis, MO, 63130, USA

    Proscovia Nabunya, Flavia Namuwonge, Vicent Ssentumbwe, Atwebembere Raymond, Ozge Sensoy Bahar & Fred M. Ssewamala

  2. International Center for Child Health and Development (ICHAD) Field Office, Masaka, Uganda

    Herbert Migadde & Winnie Kirabo

  3. College of Health Sciences, Makerere University, Kampala, Uganda

    James Mugisha

  4. Division of Computational & Data Sciences, McKelvey School of Engineering, Washington University in St. Louis, St. Louis, USA

    Najjuuko Claire

  5. Reach the Youth, Kampala, Uganda

    Abel Mwebembezi

  6. Office of the Vice Provost, Washington University in St. Louis, St. Louis, USA

    Mary M. McKay

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  1. Proscovia Nabunya
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  2. Herbert Migadde
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Correspondence to Proscovia Nabunya.

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The study is registered in the Clinical trials.gov database (Identifier #: NCT04528732).

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Nabunya, P., Migadde, H., Namuwonge, F. et al. Feasibility and Acceptability of Group-Based Stigma Reduction Interventions for Adolescents Living with HIV and Their Caregivers: The Suubi4Stigma Randomized Clinical Trial (2020–2022). AIDS Behav 28, 1630–1641 (2024). https://doi.org/10.1007/s10461-024-04284-4

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