Suubi4Stigma study protocol: a pilot cluster randomized controlled trial to address HIV-associated stigma among adolescents living with HIV in Uganda
Open accessAbstract
BACKGROUND: Sub-Saharan Africa (SSA) is heavily burdened by HIV, with 85% of the global new infections among adolescents happening in the region. With advances in medication and national policies promoting antiretroviral therapy (ART), children < 15 years living with HIV (CLWH) continue to grow with a chronic, highly stigmatized disease. Unfortunately, the stigma they experience results in much lower quality of life, including poor mental health and treatment outcomes. Family members also experience stigma and shame by virtue of their association with an HIV-infected family member. Yet, stigma-reduction interventions targeting CLWH and their families are very limited. The goal of this study is to address HIV-associated stigma among CLWH and their caregivers in Uganda. METHODS: This three-arm cluster randomized control trial, known as Suubi4Stigma, will evaluate the feasibility, acceptability, and preliminary impact of two evidence-based interventions: (1) group cognitive behavioral therapy (G-CBT) focused on cognitive restructuring and strengthening coping skills at the individual level and (2) a multiple family group (MFG) intervention that strengthens family relationships to address stigma among CLWH (N = 90, 10-14 years) and their families (dyads) in Uganda. Nine clinics will be randomized to one of three study arms (n = 3 clinics, 30 child-caregiver dyads each): (1) usual care; (2) G-CBT + usual care; and (3) MFG + usual care. Both treatment and control conditions will be delivered over a 3-month period. Data will be collected at baseline (pre-intervention) and at 3 months and 6 months post-intervention initiation. CONCLUSION: The primary aim of the proposed project is to address the urgent need for theoretically and empirically informed interventions that seek to reduce HIV-associated stigma and its negative impact on adolescent health and psychosocial well-being. As several countries in SSA grapple with care and support for CLWH, this study will lay the foundation for a larger intervention study investigating how HIV-associated stigma can be reduced to foster healthy child development-especially for CLWH as they transition through adolescence. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04528732 ; Registered August 27, 2020.
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Treatment strategies that promote emotion regulation, behavioral adjustment, and self-acceptance help improve the mental health of adolescents.
“Previous research has found that treatment strategies that promote emotion regulation, behavioral adjustment, and self-acceptance help improve the mental health of adolescents [11,15,20].”
From Effectiveness of a mindfulness and acceptance-based intervention for improving the mental health of adolescents with HIV in Uganda: An open-label trial (2024) · cites this paper as [15]
The Methods (Suubi4Stigma study arms; page unavailable) describe planned CBT sessions using emotion-focused coping, stress management, and cognitive restructuring to address negative self-beliefs in adolescents living with HIV. The Introduction (Theoretical framework; page unavailable) says these mechanisms may affect psychological outcomes. This is a study protocol, however, and does not report that the strategies improved adolescents’ mental health; it also does not establish the claim for adolescents generally. (LLM, conf=0.85)
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Self-citationPenerimaan Keluarga dengan Interaksi Sosial pada Orang dengan HIV
Purbasari, D., & Syaripudin, A. (2022) · Jurnal Keperawatan Silampari · doi:10.31539/jks.v6i1.4476 · Cited by 1 · see citing works
Tutlam, N. T., Nabunya, P., Kizito, S., Migadde, H., Ssentumbwe, V., Namuwonge, F., Najjuuko, C., Mugisha, J., Bahar, O. S., Mwebembezi, A., et al. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-025-03015-0
Self-citationDawson, S., Turner, K. M., Dawson, S., Yardley, T., & Huntley, A. L. (2025) · British Journal of General Practice · doi:10.3399/bjgp.2024.0525
Mutumba, M., Ssewamala, F. M., Nabunya, P., Matovu, F., Namatovu, P., & Nattabi, J. (2026) · Journal of the Association of Nurses in AIDS Care · doi:10.1097/jnc.0000000000000645
Self-citation
- Authors
- Nabunya, P., Ssewamala, F. M., Bahar, O. S., Michalopoulos, L. T. M., Mugisha, J., Neilands, T. B., Trani, J.-F., & McKay, M. M.
- Affiliations
- Washington University in St. Louis (US)
- Columbia University (US)
- Makerere University (UG)
- University of California, San Francisco (US)
- Corresponding author
- Nabunya, Proscovia
- ORCID
- Venue
- Pilot and Feasibility Studies
- Published
- 2022-04-29
- Volume
- 8
- Issue
- 1
- Pages
- 95-95
- ISSN
- 2055-5784 (ISSN-L)
- PMC
- PMC9052650
- OpenAlex
- W4225151213
- Cited by
- 18
- References
- 74
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 7 · 2023: 3 · 2022: 2
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Pilot and Feasibility Studies (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institute of Mental Health (R21MH121141)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Social Sciences › Safety Research › Poverty, Education, and Child Welfare
- Keywords
- adolescents living with HIV, HIV-infected children, stigma reduction interventions, group cognitive behavioral therapy, family caregivers, family relationships, coping strategies, psychosocial well-being, Uganda
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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