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A Pilot Social Norms Intervention to Engage Social Networks of Urban Adolescent Girls and Young Women in PrEP: Msichana Salama

Award Number: R34MH138249
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/10/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2029

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A Pilot Social Norms Intervention to Engage Social Networks of Urban Adolescent Girls and Young Women in PrEP: Msichana Salama - Abstract In Africa, adolescent girls and young women (AGYW) aged 15 to 24 years account for over 25% of new HIV infections. AGYW who do not complete high school are twice as likely to be HIV infected as girls who finish high school. Scalable, efficacious HIV prevention interventions are urgently needed that can reach out-of-school AGYW to reduce their risk. PrEP (pre-exposure prophylaxis) is recommended for high risk AGYW. In our prior work (R21MH114570), we used a social network strategy to recruit a cohort of mostly out-of-school AGYW in Tanzania (N=256); self-reported HIV sero-positivity among the AGYW was 12.2%, any lifetime intimate partner violence victimization was 60.2%, 19.4% reported transactional sex with their primary sexual partner, and none were using PrEP. Daily oral PrEP was only rolled out for public use in Tanzania in 2022. Social network interventions can scale up delivery of PrEP and other biomedical HIV prevention interventions to out-of-school AGYW. Network interventions can promote positive social norms to support PrEP use and adherence. Our study will assess the feasibility of a social norms intervention, Msichana Salama (Safe Girl), to increase PrEP use and adherence and sustain reductions in HIV risk behaviors (e.g., transactional sex) among networks of mostly out-of-school AGYW. The study design is a pilot intervention trial using 24 sociocentric networks of AGYW in Dar es Salaam (N=224). Specific aims are: 1) To carefully assess the feasibility and acceptability of Msichana Salama, a status-neutral intervention that integrates social norms change for PrEP use via peer ambassador/navigators and linkage to adolescent-friendly services for predominantly out-of-school AGYW ages 15-24; 2) To conduct a pilot cluster-randomized trial to provide estimates of the effect of Msichana Salama on PrEP uptake and adherence among the subset of participants who are HIV-negative and sexually active. By increasing demand through pro-PrEP norms, reducing PrEP stigma through peer leaders who will be ambassadors for PrEP use and adherence, and increasing access to PrEP through an adolescent-friendly provider, we hypothesize that Msichana Salama will reduce AGYW’s risk for HIV acquisition by promoting positive social norms to engage in PrEP uptake and adherence. All participants will receive socio-behavioral surveys, network assessments and biological assessments at baseline, two-, three-, and six-months. PrEP uptake and adherence will be assessed with dried blood spots. If there is a signal for efficacy and the intervention is feasible, findings will prepare us to conduct an appropriately powered randomized controlled trial on this intervention with significant public health potential in addressing an urban population of young women at high risk for HIV. Doing this research in Tanzania is faster and more cost efficient than trying to run the same study in the United States, because there are more adolescents at risk of HIV and programs like PrEP are already being used at scale, allowing us to test what works in a shorter time and at lower cost. If the approach works, we can bring this proven, real-world model back to the United States and use it to quickly expand and implement effective HIV prevention, increase PrEP use, and reduce new infections, which will bring us closer to ending the HIV epidemic here at home.


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 = $145,735 )
2026	2026	AMERICAN UNIVERSITY	4400 MASSACHUSETTS AVE NW	WASHINGTON	DC	20016	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	1	9/10/2026	NEW	$145,735
														Subtotal = $145,735

Grand Total All Awards = $145,735

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A Pilot Social Norms Intervention to Engage Social Networks of Urban Adolescent Girls and Young Women in PrEP: Msichana Salama

Award Number: R34MH138249

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/10/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2029

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