Participants and Recruitment

The Suubi4Stigma study was a two-year pilot cluster randomized clinical trial (2020–2022). Between November 2020 and May 2021, we recruited 89 ALHIV and their caregivers (dyads) to participate in the study. Adolescents were recruited if they met the following inclusion criteria: (1) living with HIV and aware of their status; (2) between 10 and 14 years; (3) enrolled in ART at one of the 9 study clinics; and (4) living within a family, including extended family units. Adults aged 18 + who identified as the primary caregiver of the recruited adolescent were recruited.

Participants were identified and recruited from 9 HIV health clinics located within four political districts of Masaka, Kyotera, Kalungu, and Lwengo – a region with one of the highest HIV prevalence in Uganda (11.7%) compared to the national average of 5.4% [25]. Health clinics were comparable in terms of the number of adolescents served, facility level and having adolescent clinic days. At HIV clinics, patients are seen at least annually, and each patient prescribed ART must have prescriptions filled at least monthly at each clinic. A clinic staff created a list of all eligible families from medical records, noting their eligibility to participate. Study recruitment flyers were also distributed to potential participants. During clinic appointment days, the clinic staff presented the project idea to adult caregivers of eligible children. If caregivers were interested, verbal consent to be contacted by research staff who was on site during the adolescent clinic days was requested. After speaking with the research staff one-on-one about the study, interested caregivers were taken through informed consent after which they provided written consent for themselves and for their child to participate. Adolescents were asked to provide written assent separately to avoid coercion. Both adolescents and caregivers completed assessments conducted at baseline, 3 and 6-months follow-up [28]. All participants received monetary compensation for completing the assessments, and each time they attended the intervention sessions to cover their time and transport refund.