By Jamie Hansen, Global Health Communications Manager

Building on their previous work funded by a Stanford Global Health Seed Grant,* Stanford researchers have been awarded a new $150,000 grant from the Global Grand Challenges initiative by the Bill & Melinda Gates Foundation. This innovative project aims to tackle the complex interplay of mental health, gender-based violence, and HIV outcomes among adolescent girls and young women in Kenya.

The researchers’ previous study revealed that interpersonal violence and poor mental health significantly hindered adolescent girls and young women’s ability to adhere to life-saving antiretroviral therapy (ART), resulting in adverse health outcomes. This new research builds on that groundwork by utilizing advanced large language models to develop a more nuanced understanding of how these interconnected issues impact HIV management.

“We recognize that adolescent girls and young women in Kenya face a disproportionate burden from HIV, mental health challenges, and gender-based violence. This research seeks to unravel the intricate relationships between these factors,” said Dr. Mike Baiocchi, an associate professor of epidemiology and population health. He’s leading the grant-funded effort along with Clea Sarnquist, DrPH, MPH, and Jonathan Altamirano, a PhD candidate in epidemiology and population health.

The researchers added that current survey methods often fall short in these contexts with adolescents, as they are often long and complicated. “We seek to pioneer new statistical methods that capture authentic narratives through conversational data,” Baiocchi said.

The innovative methodology will include two core components: developing a rigorous statistical approach to analyze conversational interview data and conducting a community-based, longitudinal cohort study to identify potential causal mechanisms linking gender-based violence, mental health, and HIV outcomes. This dual approach enables researchers to integrate qualitative insights with robust quantitative data, ensuring a comprehensive understanding of these complex dynamics.

To achieve this, the team will re-engage a cohort of 309 adolescent girls and young women living with HIV, leveraging existing baseline data collected in 2022. By adding a second data collection point two years later, the researchers will form a longitudinal study. 

In close collaboration with the Kenyan Medical Research Institute (KEMRI), Stanford researchers will employ diverse data collection methods, including medical chart reviews, quantitative surveys, and in-depth interviews. Researchers will then analyze the interviews using large language models to identify patterns in language linked to poor mental health, experiences with gender-based violence, and adverse HIV outcomes.

Dr. Sarnquist, a clinical associate professor of pediatrics specializing in infectious diseases, emphasized the project’s potential to benefit the physical and mental health of adolescents and young women.

“By harnessing the power of natural language processing and conversational data, we can support young women in navigating their mental health and experiences of violence while effectively managing their HIV care,” she said. “This research represents a significant methodological leap forward in collecting and analyzing data that will allow us to identify and begin to address the barriers these vulnerable populations face.”

The grant builds on the preliminary field work that Altamirano conducted as part of his dissertation and will support his ongoing research to generate estimates of how ART adherence would be improved with effective interventions for poor mental health and gender-based violence. “Having collaborated with Dr. Hellen Barsosio, Corrie Mevis, and our KEMRI colleagues for six years on studies of HIV care in emerging adults, I’m thrilled to expand this work to include both rigorous methodology and new innovative ways to incorporate insights from qualitative data,” he said.

Supported by the Global Grand Challenges initiative — a Gates Foundation-funded family of initiatives fostering innovation to solve key global health and development problems, this research promises to provide critical insights and practical interventions for adolescent girls and young women grappling with these interconnected challenges in Kenya and beyond.

*The 2020 Stanford Global Health Seed Grant that supported this work was co-funded by the Stanford Maternal & Child Health Research Institute and the Stanford Center for Innovation in Global Health.