Scientist awarded $5 million to improve mental health and HIV care for adolescents in Uganda

The National Institutes of Health (NIH) has awarded Dr. Philip Kreniske, Assistant Professor at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), $5,115,391 for a groundbreaking research project to improve mental health and antiretroviral treatment adherence among adolescents living with HIV in rural Uganda.

The study, Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS), addresses critical gaps in care for young people living with both HIV and depression.

Adolescents living with HIV face unique challenges that can affect both their mental health and their ability to maintain treatment. In low- and middle-income countries, one in four adolescents with HIV experiences poor mental health, a major factor that contributes to missed medications and lack of viral suppression.

However, this creates a major gap between the need for mental health services and the availability of evidence-based care. This gap is especially critical in sub-Saharan Africa, home to the majority of the world’s 1.7 million adolescents living with HIV, where few evidence-based mental health interventions have been proven effective for young people.

HIV clinics

The STREAMS study will be implemented across 24 HIV clinics affiliated with the International Center for Child Health and Development (ICHAD) in Uganda’s Masaka region, using a cluster-randomized trial to evaluate the effectiveness of the intervention in reducing depressive symptoms and improving medication adherence. The researchers will also explore barriers and facilitators to care.

“STREAMS stands on the shoulders of giants—decades of work, from the biomedical breakthroughs in HIV treatment and the historic distribution through PEPFAR, to the careful adaptation of mental health programs in Uganda,” says Kreniske, an investigator at the CUNY Institute for Implementation Science in Population Health (ISPH). “Our innovation is to take these proven, life-saving tools and combine them. By leveraging simple mobile technology for mental health screening, we can integrate mental health, economic empowerment, and medication support into a single, powerful system for youth. This approach can transform young lives and offer insights for improving community mental health care worldwide.”

Scalable services

The study is expected to provide critical evidence to guide scalable mental health and HIV treatment services for adolescents in sub-Saharan Africa.

“What makes STREAMS so important is its focus on testing evidence-based interventions in real-world service delivery settings, with attention to feasibility and scalability should it be found to be impactful,” says CUNY SPH Distinguished Professor Denis Nash, executive director of CUNY ISPH.

Dr. Kreniske will work in collaboration with Dr. Proscovia Nabunya from Washington University, CUNY SPH faculty Drs. Chloe Teasdale and Sasha Fleary, and investigators from the New York University Silver School of Social Work and StrongMinds, which provides free, evidence-based, culturally relevant mental health care to the world’s most under-resourced populations.

Research reported in this press release was supported by the National Institute of Mental Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award numbers K01MH122319 and R01HD074949.