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A total school approach using safeguarding to address HIV-related stigma and discrimination in boarding schools in Zambia

Award Number: R01TW012663
ORGANIZATION: FOGARTY INTERNATIONAL CENTER
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/09/2024
PERIOD OF PERFORMANCE END DATE: 07/31/2027

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A total school approach using safeguarding to address HIV-related stigma and discrimination in boarding schools in Zambia - PROJECT SUMMARY HIV-related stigma is a known obstacle to optimal health and HIV outcomes. Institutional environments can be characterized by cultures of physical, verbal, and sexual abuse strongly linked to stigma; all particularly concerning in youth institutions. US literature has largely examined HIV stigma and institutional maltreatment in isolation, leaving significant gaps in understanding how stigma-related social processes may contribute to abuse risk and adverse health outcomes among vulnerable adolescents [1,2]. Safeguarding can address both stigma and abuse. Zambia has recently developed national safeguarding guidelines for schools and has a long history of both stigma research and interventions. Leveraging this in the context of Zambia’s HIV burden will provide rich data to meaningfully understand HIV-related stigma and abuse. Given the similarity in institutional contexts across these settings (e.g., separation from parental/ familial supports, potentially punitive environments, intensified peer interactions), these findings can inform institutional interventions within the US [3,4]. This study responds to the challenges of making institutions safe, stigma-free havens with reduced risk behaviors and improved health outcomes for young people. Building on evidence that addressing HIV stigma can disrupt the cycle of violence that is both cause and consequence of HIV risk and vulnerability, this study’s objective is to pilot test and evaluate a ‘total school approach’ to addressing HIV-related stigma in boarding schools, embedded in a safeguarding framework. We will co-create stigma reduction interventions at two boarding schools in Zambia. Learners, teachers, and staff will be trained to then deliver trainings to 80% of each school’s population. Aim 1 is a formative phase to adapt a ‘total facility approach’ for addressing stigma in healthcare to the boarding school setting, and to co-create, with the study school communities, an intervention package, using a safeguarding approach. For Aim 2, we will carry out a paired pre-post study to pilot test the impact of the intervention. For Aim 3, a mixed-methods process evaluation will explore how the school environment affects its population’s attitudes and behaviors. The primary outcome measures will be self-reported experience of abuse and stigmatizing attitudes relating to HIV. Mixed-methods approaches will provide insight into why different elements of the intervention worked/did not work and maximize learning about implementation of this approach to fostering a safe institutional environment, free from stigma to improve HIV-related outcomes. Findings from the Zambian context can inform trauma-informed stigma reduction and child-protection interventions for vulnerable youth populations in the US [5,6].


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $163,235 )
2026	2026	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90033	LOS ANGELES	USA	International Research and Research Training	001	3	7/23/2026	SUPPLEMENT FOR EXPANSION	$135,620
2026	2026	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90033	LOS ANGELES	USA	International Research and Research Training	000	3	7/14/2026	NON-COMPETING CONTINUATION	$27,615
														Subtotal = $163,235

Issue Date FY: 2025 ( Subtotal = $164,845 )
2025	2025	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90033	LOS ANGELES	USA	International Research and Research Training	001	2	9/10/2025	NON-COMPETING CONTINUATION	$164,845
2025	2024	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90033	LOS ANGELES	USA	International Research and Research Training	000	1	4/14/2025	NEW	$0
														Subtotal = $164,845

Issue Date FY: 2024 ( Subtotal = $185,040 )
2024	2024	UNIVERSITY OF SOUTHERN CALIFORNIA	3720 S FLOWER ST FL 3	LOS ANGELES	CA	90033	LOS ANGELES	USA	International Research and Research Training	000	1	8/5/2024	NEW	$185,040
														Subtotal = $185,040

Grand Total All Awards = $513,120

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A total school approach using safeguarding to address HIV-related stigma and discrimination in boarding schools in Zambia

Award Number: R01TW012663

ORGANIZATION: FOGARTY INTERNATIONAL CENTER

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/09/2024

PERIOD OF PERFORMANCE END DATE: 07/31/2027

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