Uganda will receive over $5.1 million to support a new health initiative that seeks to transform adolescent HIV care and mental health services.

 

The US National Institutes of Health (NIH) has awarded the CUNY Graduate School of Public Health and Health Policy (CUNY SPH) a $5,115,391 grant to fund the Streams project (Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support), in Uganda that will be led by Philip Kreniske, an assistant professor at CUNY SPH.

Implemented in 24 rural clinics, Streams will integrate HIV treatment support with mental health care and economic empowerment for adolescents living with HIV in Uganda.

It aims to close persistent mental health gaps among young people, boost adherence to antiretroviral therapy, and develop scalable models for adolescent HIV care in sub-Saharan Africa.“Adolescents living with HIV face unique and intersecting challenges that go beyond clinical care,” said Proscovia Nabunya from Washington University, who is collaborating on the project.

Despite major gains in HIV testing and treatment, adolescents remain one of Uganda’s most vulnerable groups, lagging behind adults and children in achieving viral suppression.

Rural facilities often lack integrated mental health care, leaving depression and anxiety, key drivers of poor adherence, largely undetected and untreated.

For adolescents living in poverty, mental health struggles are compounded by economic stressors such as school dropout, unemployment and food insecurity, all of which increase the risk of treatment interruption.“The programme will prioritise early detection and management of depression and anxiety, ensuring that young people receive the mental health support they need to remain in care,” said a press release from CUNY Graduate School of Public Health and Health Policy.“It will also integrate economic empowerment initiatives designed to ease financial stress, build resilience, and promote self-reliance among adolescents. In addition, the programme will provide HIV treatment support tailored to adolescents’ developmental needs, with a strong focus on adherence, peer networks, and youth-friendly services.”“Streams stands on the shoulders of giants,” said Dr Kreniske. “From the biomedical breakthroughs in HIV treatment and Pepfar’s historic distribution, to Uganda’s adaptation of mental health programmes, our aim is to combine these proven tools. By leveraging simple mobile technology, we can integrate mental health, economic empowerment and medication support into a single, powerful system for youth.”The findings are expected to directly inform Uganda’s adolescent health and HIV strategies, offering evidence for integrated care in resource-limited settings.

If successful, the model could guide national guidelines and be replicated in other African countries facing similar challenges.

The investment comes as donors and governments increasingly recognise the need for integrated approaches to adolescent health.

Traditional vertical programming, where mental health, economic support and HIV care operate in silos, has struggled to deliver lasting improvements.

Globally, mental health is now seen as a key determinant of HIV outcomes, with depression linked to lower adherence rates and higher viral loads, and economic stress exacerbating these risks.

The initiative also comes at a critical moment when the future of the US President’s Emergency Plan for AIDS Relief (Pepfar), a cornerstone of HIV funding in Africa for more than two decades, faces uncertainty as Washington debates its reauthorization.

For countries like Uganda, which have relied heavily on Pepfar support, there is growing pressure to adopt sustainable, locally anchored solutions. It is believed Streams could offer a blueprint for such transitions, contributing to the global goal of ending AIDS as a public health threat by 2030.

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