Among sub-Saharan nations in Africa, Rwanda has achieved significant progress toward achieving epidemic control of human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS). In 2013, UNAIDS, a United Nations initiative, announced a campaign referred to as 90-90-90. These goals targeted 90 percent of people knowing their HIV/AIDS status, 90 percent of infected people on antiretroviral therapy and 90 percent virally suppressed. By 2015, Rwanda had achieved totals of 88, 83 and 86 percent in these respective areas.
Despite these successes, AIDS-related deaths among sub-Saharan youth have tripled since 2000, and AIDS remains the leading cause of death among adolescents. With the adolescent population worldwide expected to grow, viral suppression in this group is essential to avoid HIV resistant mutations, virologic failure and future HIV transmission.
Adolescents living with HIV suffer high rates of mental health symptoms, especially depression and trauma. In Rwanda, these symptoms are associated in part with the country’s legacy of the genocide. Across populations, mental health concerns are linked to low antiretroviral adherence, critical to sustain viral suppression and prevent onward transmission.
Dr. Geri Donenberg, associate dean for research at the University of Illinois at Chicago (UIC) School of Public Health from 2012-2018, served as the a principal investigator with Drs. Mardge Cohen and Sabin Nsanzimana for the Kigali Imbereheza Project, a randomized controlled trial based in Kigali, Rwanda that sought to test an adherence-enhanced, developmentally appropriate, culturally adapted trauma informed cognitive behavioral intervention (TI-CBTe) on antiretroviral therapy adherence among Rwandan youth living with HIV.Friday Letter Submission, Publish on March 13