The impact of forced migration on HIV vulnerability and prevention among internally displaced adolescent girls and young women in northern Mozambique

PROJECT SUMMARY
Exposure to traumatic events is associated with increased HIV risk in adults, however for young, forcibly
displaced persons this relationship is less clear. An insurgency in northern Mozambique has internally
displaced >1 million inhabitants from Cabo Delgado province. Moreover, Mozambique has an HIV prevalence
of 11.5% and adolescent girls and young women (AGYW; ages 15–24) in sub-Saharan Africa account for 63%
of all new infections. It is critical to investigate how forced migration can impact internally displaced
Mozambican AGYW's vulnerability to HIV and devise relevant strategies to mitigate this potential effect.
Individuals may encounter a range of traumatic stressors (violence, conflict, family separation, etc.,) throughout
their displacement journeys. Few studies have examined traumatic stressors specific to displacement as
predictors of HIV vulnerability, particularly for AGYW in sub-Saharan Africa. Similarly, trauma informed HIV
prevention could prove beneficial to displaced AGYW, however it has yet to be delivered in humanitarian
settings. The proposed F31 responds to these research and practice gaps by engaging with recently displaced
AGYW in northern Mozambique to determine predictors of HIV vulnerability for this population (Aim 1) and
explore HIV prevention implementation strategies for AGYW in contexts of displacement (Aim 2). In Aim 1a., I
will employ mediation analysis to determine the relationship between exposure to (traumatic) stressors related
to displacement, common mental disorders, and HIV risk behaviors. In Aim1b., I will use latent class analysis
to create displacement stressor profiles for AGYW and then identify which classes of the sample confer the
highest level of HIV risk. The results of these aims will inform Aim 2: a needs assessment for the development
of a trauma-informed HIV prevention implementation strategy for displaced AGYW.
The outcomes of this study will contribute to HIV prevention efforts for displaced AGYW in Mozambique.
Studying the impact of forced migration on HIV vulnerability and HIV prevention for AGYW in Mozambique is
critical to understanding its influence on HIV prevention efforts in other regions of sub-Saharan Africa and
globally. The F31 fellowship will provide the candidate a specialized training in advanced quantitative methods,
HIV prevention implementation science, forced migration and health, and leading global health research
teams. This training, and the multidisciplinary mentorship team, will prepare the candidate for a career as a
HIV and mental health social epidemiologist conducting research in forced migration contexts and developing
trauma-informed HIV prevention strategies for displaced AGYW in sub-Saharan Africa.

Grant Number: 5F31MH136948-02
NIH Institute/Center: NIH
Principal Investigator: Catherine Chantre