Kyaterekera Project (2018-2023)

Principal Investigator: Fred M. Ssewamala, PhD; Susan Witte, PhD (Columbia University)

Project Team Members: Ozge Sensoy Bahar, PhD; Larissa Jennings, PhD (University of Carolina at Chapel Hill); Joseph Kagaayi, PhD (Rakai Health Sciences Program); Proscovia Nabunya, PhD; Yesim Tozan, PhD (New York University)

Field Coordinators: Edward Nsubuga

Research Collaborators: Abel Mwebembezi (Reach the Youth-Uganda)

Kyaterekera Project: A Combination Intervention Addressing Sexual Risk-Taking Behaviors among Vulnerable Women in Uganda, is a 5-year longitudinal study (2018-2023) funded by the National Institute of Mental Health (NIMH). Using a randomized clinical trial, it examines the impact of and costs associated with Kyaterekera, an innovative combination intervention that adds economic empowerment components to traditional HIV risk reduction sessions to reduce new incidence of sexually transmitted infections and HIV among female sex workers in the greater Masaka region and provide alternative means of safe and sustainable income to replace sex work.

COVID-19 and Health Disparities Research Pilot (2023-2025)

Study Title: Addressing the impact of COVID-19 and associated measures on PrEP use among economically vulnerable women in Uganda

Principal Investigators: Proscovia Nabunya, PhD; Anita Kabarambi, MBChB

Funding: Brown School at Washington University in St. Louis supported by the Neidorff Family and Centene Corporation COVID & Health Disparity Response Fund.

This study seeks to assess the impact of COVID-19 and associated measures on PrEP use among women engaged in sex work (WESW). We will also test the feasibility and acceptability of a peer support intervention to address barriers associated with PrEP access and continuity.

Kyaterekera Study Publications

Kiyingi J, Mayo-Wilson LJ, Nabunya P, Kizito S, Nabayinda J, Nattabi J, Nsubuga E, Sensoy Bahar O, Namuwonge F, Nakabuye F, Nanteza F, Filippone PL, Mukasa D, Witte SS, Ssewamala FM. Examining the Intrapersonal, Interpersonal and Community Level Correlates of Access to Medical Care Among Women Employed by Sex Work in Southern Uganda: A cross-sectional Analysis of the Kyaterekera Study. AIDS Behav. 2024 Apr 12. doi: 10.1007/s10461-024-04333-y. Springer

Nabayinda J, Witte SS, Kizito S, Nanteza F, Nsubuga E, Sensoy Bahar O, Nabunya P, Ssewamala FM. The impact of an economic empowerment intervention on intimate partner violence among women engaged in sex work in southern Uganda. A cluster randomized control trial. Social Science & Medicine. 2024 April 3. doi.org/10.1016/j.socscimed.2024.116846. Science Direct

Tozan Y, Kiyingi J, Kim S, Sensoy Bahar O, Nabayinda J, Namuwonge F, Nsubuga E, Nakabuye F, Sensoy Bahar O, Nabunya P, Jennings Mayo-Wilson L, McKay MM, Witte SS, Ssewamala FM. Costing of a combination intervention (Kyaterekera) addressing sexual risk-taking behaviors among vulnerable women in southern Uganda. American Journal of Tropical Medicine & Hygiene. 2024 April 2. doi: https://doi.org/10.4269/ajtmh.23-0485. The American Journal of Tropical Medicine and Hygiene

Yang LS, Witte SS, Kiyingi J, Nabayinda J, Nsubuga E, Nabunya P, Sensoy Bahar O, Jennings Mayo-Wilson L, Ssewamala FM. Conducting high-frequency data collection in low-resource settings: Lessons from a financial diary study among women engaged in sex work in Uganda. Journal of Human Behavior in the Social Environment. 2023 June 30. doi.org/10.1080/10911359.2023.2229404. Taylor & Francis Online

Nabayinda J, Namirembe R, Kizito S, Nsubuga E, Nabunya P, Sensoy Bahar O, Magorokosho N, Kiyingi J, Nattabi J, Tozan Y, Jennings Mayo-Wilson L, Mwebembezi A, Witte SS, Ssewamala FM. Correlates of Intimate Partner Violence Among Young Women Engaged in Sex Work in Southern Uganda. J Interpers Violence. 2023 May 22:8862605231175908. doi: 10.1177/08862605231175908. SAGE

Jennings Mayo-Wilson L, Peterson SK, Kiyingi J, Nabunya P, Sensoy Bahar O, Yang LS, Witte SS, Ssewamala FM. Examining Cash Expenditures and Associated HIV-Related Behaviors Using Financial Diaries in Women Employed by Sex Work in Rural Uganda: Findings from the Kyaterekera Study. International Journal of Environmental Research and Public Health. 2023; 20(9):5612. https://doi.org/10.3390/ijerph20095612. International Journal of Environmental Research and Public Health

Sensoy Bahar O, Nabunya P, Nabayinda J, Witte S, Kiyingi J, Nsubuga E, Schriger S, Nattabi J, Mayo-Wilson LJ, Nakigudde J, Tozan Y, Ssewamala FM. “I decided in my heart I have to complete the sessions”: A qualitative study on the acceptability of an evidence-based HIV risk reduction intervention among women engaged in sex work in Uganda. PLoS One. 2023 Jan 12;18(1): e0280138. doi: 10.1371/journal.pone.0280138. Plos One

Nabayinda J, Kiyingi J, Nsubuga E, Kizito S, Nabunya P, Sensoy Bahar O, Magorokosho N, Nattabi J, Witte SS, Ssewamala FM. Does asset ownership influence sexual risk-taking behaviors among women engaged in sex work in Southern Uganda? A Mediation Analysis. BMC Women’s Health. Dec 2022, 22, https://doi.org/10.1186/s12905-022-02129-7. BMC

Kiyingi J, Nabunya P, Sensoy Bahar O, Mayo-Wilson LJ, Tozan Y, Nabayinda J, Namuwonge F, Nsubuga E, Kizito S, Nattabi J, Nakabuye F, Kagayi J, Mwebembezi A, Witte SS, Ssewamala FM. Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda. PLoS One. 2022;17(9):e0273238.PubMed

Nabayinda J, Kizito S, Witte S, Nabunya P, Kiyingi J, Namuwonge F, Nsubuga E, Sensoy Bahar O, Jennings Mayo-Wilson L, Yang LS, Nattabi J, Magorokosho N, Ssewamala FM. Factors associated with consistent condom use among women engaged in sex work. Lessons from Kyaterekera study in Southern Uganda. AIDS and Behavior. 2022 Sept 16. Springer

Kiyingi J, Nabunya P, Kizito S, Nabayinda J, Nsubuga E, Sensoy Bahar O, Jennings Mayo-Wilson L, Tozan Y, Namuwonge F, Nattabi J, Magorokosho N, Witte SS, Ssewamala FM. Self-reported adherence to antiretroviral therapy (ART) among women engaged in commercial sex work in Southern Uganda. AIDS and Behavior. 2022 Sept 06. Springer

Sensoy Bahar, O., Nabunya, P., Nabayinda, J., Witte, S. S., Kiyingi, J., Mayo-Wilson, L. J., Filippone, P., Yang, L. S., Nakigudde, J., Tozan, Y., & Ssewamala, F. M. (2022). “I expected little, although I learned a lot”: perceived benefits of participating in HIV risk reduction sessions among women engaged in sex work in Uganda. BMC women’s health, 22(1), 162. PubMed

Jennings Mayo-Wilson, L., Yen, B. J., Nabunya, P., Bahar, O. S., Wright, B. N., Kiyingi, J., Filippone, P. L., Mwebembezi, A., Kagaayi, J., Tozan, Y., Nabayinda, J., Witte, S. S., & Ssewamala, F. M. (2022). Economic Abuse and Care-seeking Practices for HIV and Financial Support Services in Women Employed by Sex Work: A Cross-Sectional Baseline Assessment of a Clinical Trial Cohort in Uganda. Journal of interpersonal violence, 8862605221093680. Advance online publication. PubMed.

Witte, S. S., Filippone, P., Ssewamala, F. M., Nabunya, P., Bahar, O. S., Mayo-Wilson, L. J., Namuwonge, F., Damulira, C., Tozan, Y., Kiyingi, J., Nabayinda, J., Mwebembezi, A., Kagaayi, J., & McKay, M. (2022). PrEP acceptability and initiation among women engaged in sex work in Uganda: Implications for HIV prevention. EClinicalMedicine, 44, 101278. Science Direct

Nabunya ,P., Kiyingi, J., Witte, S. S., Sensoy Bahar, O., Jennings Mayo-Wilson, L., Tozan, Y., Nabayinda, J., Mwebembezi, A., Tumwesige, W., Mukasa, B., Namirembe, R., Kagaayi, J., Nakigudde, J., McKay, M. M., & Ssewamala, F. M. (2021). Working with economically vulnerable women engaged in sex work: Collaborating with community stakeholders in Southern Uganda. Global Public Health 1-7 Global Public Health

Nabunya, P., Byansi, W., Damulira, C., Sensoy Bahar, O., Jennings Mayo-Wilson, L., Tozan, Y., Kiyingi, J., Nabayinda, J., Brathwaite, R., Witte, S. S., Ssewamala, F. M. (2021). Predictors of depressive symptoms and post-traumatic stress disorder among women engaged in commercial sex work in southern Uganda. Psychiatry Research. ScienceDirect

Ssewamala, F. M., Bahar, O. S., Tozan, Y., Nabunya, P., Mayo-Wilson, L. J., Kiyingi, J., … & Witte, S. S. (2019). A combination intervention addressing sexual risk-taking behaviors among vulnerable women in Uganda: study protocol for a cluster randomized clinical trial. BMC Women’s Health, 19(1), 111. Springer