Dr. Jennifer Belus

Adolescents and young adults in sub-Saharan Africa are facing increasing threats to health and overall quality of life.This project seeks to address adolescent and young adult well-being by simultaneously tackling alcohol and other drug (AOD) use, inequitable gender beliefs, and high rates of unemployment in Zambia, Zimbabwe, and South Africa. Specifically, this project aims to develop and test a brief, behavioral intervention to reduce problem AOD use and gender inequitable beliefs, which will be delivered to adolescent and young adult peer groups and embedded within existing vocational training programs. The study will also assess vocational training program characteristics that may facilitate or hinder scaling up of the proposed intervention, should it be successful. This study is conducted in collaboration with the University of Zambia, SolidarMed Zambia and Zimbabwe, and the South African Medical Research Council. The study is funded through the Solution-oriented Research for Development Programme, which is jointly funded by SNSF and SDC (Grant no. 400440_213259).

Studying if men living with HIV who hold unhelpful idealized beliefs about masculinity have more difficulty disclosing their HIV status, and in turn, are less likely to be retained in HIV care. This study is conducted in collaboration with the University of Cape Town and the University of Maryland and is funded by the US National Institute of Mental Health (Grant no. R21MH123280).

LoDoCA was a prospective cohort study among children and adolescents with HIV in Lesotho, southern Africa who changed from an antiretroviral therapy regimen containing ritonavir-boosted lopinavir to a regimen containing dolutegravir. The study compared treatment satisfaction and previously reported adverse effects of either drug, including neuropsychiatric (sleep, depression) and gastrointestinal outcomes. Sleep was a key focus, as sleep disturbance had previously been reported as an adverse effect of dolutegravir among adults. Thus, sleep was measured by actigraphy (movement-sensing devices worn by participants around their wrist from around bedtime to morning) in addition to questionnaires.

For many people living in rural settings in Lesotho, weekly attendance for behavioral intervention sessions to address mental health and substance use can be challenging. In this study, we will test whether one in-person session plus standardized SMSs is superior to a 4-session in-person intervention, delivered by non-specialist mental health providers. This project is conducted in collaboration with SolidarMed Lesotho and is funded by an Ambizione grant through the Swiss National Science Foundation (Grant no. PZ00P1_201690).

Community Based Chronic Care Lesotho (ComBaCaL) is a collaborative program between Lesotho and Switzerland dedicated to developing, testing, and sharing innovative solutions to enhance chronic disease care in remote settings in low- and middle-income countries.

At the core of ComBaCaL is the concept of Community Health Workers (CHWs) supported by a digital clinical decision support system, enabling them to provide treatment for selected conditions in remote areas with limited access to clinics.

In phase 1, we empowered CHWs to independently prescribe and manage treatment of uncomplicated hypertension and type 2 diabetes. This approach was effective in large cluster-randomised trials.

In the current phase 2, the focus has expanded to integrated care packages addressing a wider range of conditions, including HIV, sexual and reproductive health, and health services for children under five. The aim of this phase is to prepare ComBaCaL for scale.

For detailed information and a comprehensive list of our publications, visit: www.combacal.org.

This study pilot tests "Supporting Treatment for Anti-Retroviral Therapy (START) Together" vs referral for ART adherence counseling in order to improve adherence in women living with HIV. Conducted in collaboration with the Human Sciences Research Council and funded by the Canadian Institutes of Health Research.

In settings such as Lesotho, where young women face enormous HIV and sexual and reproductive health (SRH) challenges, novel and accessible spaces to complement traditional health facilities are urgently needed. HIV- and pregnancy-related complications are still the leading cause of death among young women in high HIV prevalence settings in Southern Africa. 

Hair salons may offer a safe, accessible, trusted community space to engage young women and address barriers related to HIV/SRH.

In a first step, we concluded an innovative cross-sectional survey – co-designed and conducted in collaboration with citizen scientists – and gathered data among 100 hair stylists and 300 clients across Lesotho. The findings were complemented by qualitative research, narrative storytelling and a video documentary.

In a next step, we are designing and implementing a pilot to evaluate a first HIV/SRH service intervention at a few hair salons in Lesotho.