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Principal Investigator: Catherine Lima Chantre
Organization: YALE UNIVERSITY
Fiscal Year: 2024
Award: $51,974
Funding agency: National Institute of Mental Health
PROJECT SUMMARY
Exposure to traumatic events is associated with increased HIV risk in adults, however for young, forcibly
displaced persons this relationship is less clear. An insurgency in northern Mozambique has internally
displaced >1 million inhabitants from Cabo Delgado province. Moreover, Mozambique has an HIV prevalence
of 11.5% and adolescent girls and young women (AGYW; ages 15–24) in sub-Saharan Africa account for 63%
of all new infections. It is critical to investigate how forced migration can impact internally displaced
Mozambican AGYW's vulnerability to HIV and devise relevant strategies to mitigate this potential effect.
Individuals may encounter a range of traumatic stressors (violence, conflict, family separation, etc.,) throughout
their displacement journeys. Few studies have examined traumatic stressors specific to displacement as
predictors of HIV vulnerability, particularly for AGYW in sub-Saharan Africa. Similarly, trauma informed HIV
prevention could prove beneficial to displaced AGYW, however it has yet to be delivered in humanitarian
settings. The proposed F31 responds to these research and practice gaps by engaging with recently displaced
AGYW in northern Mozambique to determine predictors of HIV vulnerability for this population (Aim 1) and
explore HIV prevention implementation strategies for AGYW in contexts of displacement (Aim 2). In Aim 1a., I
will employ mediation analysis to determine the relationship between exposure to (traumatic) stressors related
to displacement, common mental disorders, and HIV risk behaviors. In Aim1b., I will use latent class analysis
to create displacement stressor profiles for AGYW and then identify which classes of the sample confer the
highest level of HIV risk. The results of these aims will inform Aim 2: a needs assessment for the development
of a trauma-informed HIV prevention implementation strategy for displaced AGYW.
The outcomes of this study will contribute to HIV prevention efforts for displaced AGYW in Mozambique.
Studying the impact of forced migration on HIV vulnerability and HIV prevention for AGYW in Mozambique is
critical to understanding its influence on HIV prevention efforts in other regions of sub-Saharan Africa and
globally. The F31 fellowship will provide the candidate a specialized training in advanced quantitative methods,
HIV prevention implementation science, forced migration and health, and leading global health research
teams. This training, and the multidisciplinary mentorship team, will prepare the candidate for a career as a
HIV and mental health social epidemiologist conducting research in forced migration contexts and developing
trauma-informed HIV prevention strategies for displaced AGYW in sub-Saharan Africa.
Terms: <21+ years old><AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV test><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Adolescent HIV risk><Adult><Adult Human><Affect><Africa South of the Sahara><Age><Anxiety><Behavioral><Cities><Conflict><Conflict (Psychology)><Couples><Cross Sectional Analysis><Cross-Sectional Analyses><Cross-Sectional Studies><Cross-Sectional Survey><Data><Development><Disease Frequency Surveys><Emergencies><Emergency Situation><Epidemiologist><Equation><Exposure to><Family><Fellowship><Female Adolescents><Focus Groups><HIV><HIV Infections><HIV Prevention><HIV risk><HIV risk among adolescents><HIV test><HIV-1 test><HIV-2 test><HIV/AIDS prevention><HTLV-III Infections><HTLV-III-LAV Infections><Health><Health Care Providers><Health Personnel><Health Services><Health Status><Healthcare Providers><Healthcare worker><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Human immunodeficiency virus test><Individual><Infection><Intervention><Intervention Strategies><Interview><LAV-HTLV-III><Level of Health><Lymphadenopathy-Associated Virus><Mediating><Mediation><Mediator><Mental Depression><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Mental disorders><Mental health disorders><Mentors><Mentorship><Methods><Modeling><Mozambique><Needs Assessment><Negotiating><Negotiation><Outcome Study><PTSD><Persons><Population><Portuguese East Africa><Post-Traumatic Neuroses><Post-Traumatic Stress Disorders><Posttraumatic Neuroses><PrEP><Prevalence><Preventative strategy><Prevention><Prevention strategy><Preventive strategy><Province><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Research><Research Infrastructure><Risk Behaviors><Risky Behavior><Role><Sampling><Scientist><Sexual Partners><Societies><Stress><Sub-Saharan Africa><Subgroup><Subsaharan Africa><Survey Instrument><Surveys><Training><Trauma><Violence><Virus-HIV><Vulnerable Populations><Woman><Work><adolescent HIV prevention><adolescent girl><adulthood><ages><at risk behavior><career><community based care><condoms><depression><developmental><disease risk><disorder risk><displaced people><displaced person><experience><forced migrant><global health><health care personnel><health care worker><health level><health provider><health workforce><healthcare personnel><high risk><implementation science><implementation strategy><informant><initiation of sexual activity><interpersonal psychotherapy><interpersonal therapy><interventional strategy><intimate partner violence><involuntary migration><medical personnel><mental health care><mental healthcare><mental illness><migration><multidisciplinary><post-trauma stress disorder><posttrauma stress disorder><pre-exposure prophylaxis><psychiatric illness><psychological disorder><research study><sex partner><sexual debut><sexual initiation><sexual violence><sexually violent><social><social role><strategies for implementation><stressor><tool><transactional sex><traumatic event><traumatic neurosis><treatment provider><violent><violent behavior><vulnerable group><vulnerable individual><vulnerable people><young woman>