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Marta Mulawa

Assistant Professor in the School of Nursing
School of Nursing
307 Trent Drive, Durham, NC 27710

Selected Publications


A Hybrid Pragmatic and Factorial Cluster Randomized Controlled Trial for an Anti-racist, Multilevel Intervention to Improve Mental Health Equity in High Schools.

Journal Article Prevention science : the official journal of the Society for Prevention Research · July 2024 Systemic racism is pervasive in US society and disproportionately limits opportunities for education, work, and health for historically marginalized and minoritized racial and ethnic groups, making it an urgent issue of social justice. Because systemic rac ... Full text Cite

MASI, a Smartphone App to Improve Treatment Adherence Among South African Adolescents and Young Adults With HIV: Protocol for a Pilot Randomized Controlled Trial.

Journal Article JMIR research protocols · September 2023 BackgroundAdolescents and young adults with HIV repeatedly demonstrate low rates of antiretroviral therapy (ART) adherence as well as low rates of viral suppression. Digital health interventions are a promising way to engage adolescents and young ... Full text Cite

Interventions to Improve Adolescent HIV Care Outcomes.

Journal Article Current HIV/AIDS reports · August 2023 Purpose of reviewThis review of recent studies evaluating interventions to improve HIV care outcomes among adolescents with HIV (AHIV) was conducted to provide a comprehensive overview of the recent evidence, highlight promising approaches, and su ... Full text Cite

Development and implementation of a process evaluation for intervention quality improvement of a community-based behavioral HIV intervention trial in Tanzania.

Journal Article Zeitschrift fur Gesundheitswissenschaften = Journal of public health · June 2023 AimProcess evaluations for social and behavioral interventions are increasingly important as interventions become more complex and multi-faceted. Conducting process evaluations in low-resource international settings can be challenging. Process eva ... Full text Cite

Supporting Adolescents With HIV in South Africa Through an Adherence-Supporting App: Mixed Methods Beta-Testing Study.

Journal Article JMIR formative research · June 2023 BackgroundNovel smartphone app-delivered interventions have the potential to improve HIV treatment adherence among adolescents with HIV, although such interventions are limited. Our team has developed Masakhane Siphucule Impilo Yethu (MASI; Xhosa ... Full text Cite

Intimate partner violence perpetration and sexual risk behaviour: Identifying shared determinants among young men in Tanzania.

Journal Article Global public health · November 2022 In this study we examined factors that predict involvement in different patterns of sexual risk behavior and IPV perpetration among young men in Tanzania (n = 979), with a focus on identifying factors that distinguish men who engage in both behaviou ... Full text Cite

Predictors of Willingness to Diffuse PrEP Information within Ego-Centric Networks of Women Who Inject Drugs.

Journal Article AIDS and behavior · June 2021 Little is known about how social networks among women who inject drugs (WWID) can be leveraged to increase awareness about pre-exposure prophylaxis (PrEP). We tested the hypothesis that interpersonal characteristics influence willingness of WWID to communi ... Full text Cite

Prevalence and Risk Factors of Women's Past-Year Physical IPV Perpetration and Victimization in Tanzania.

Journal Article Journal of interpersonal violence · February 2021 Recent studies of intimate partner violence (IPV) in high-resource countries suggest that men and women may perpetrate similar rates of violence against their partners, yet the prevalence and etiology of female-perpetrated IPV, especially in comparison wit ... Full text Cite

Effects of Nurse-Delivered Cognitive Behavioral Intervention on Depression and Anxiety for Persons Living With HIV in China: A Clinical Controlled Trial.

Journal Article The Journal of the Association of Nurses in AIDS Care : JANAC · January 2021 AbstractDepression and anxiety, which may influence antiretroviral therapy (ART) medication adherence, are prevalent among persons living with HIV (PLWH) in China. This parallel two-arm clinical controlled trial aimed to examine the effects of a n ... Full text Cite

Cognitive behavioral therapy for persons living with HIV in China: A randomized pilot trial.

Journal Article Journal of affective disorders · December 2020 BackgroundChinese persons living with HIV (PLWH) suffer from prevalent mental health issues. We aimed to develop a tailored cognitive behavioral therapy (CBT), test its feasibility, acceptability, and preliminary effects (depression, anxiety, and ... Full text Cite

Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial.

Journal Article JMIR research protocols · December 2020 BackgroundStigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgend ... Full text Cite

Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial (Preprint)

Journal Article · September 4, 2020 BACKGROUNDStigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among yo ... Full text Cite

Results from a cluster-randomized trial to evaluate a microfinance and peer health leadership intervention to prevent HIV and intimate partner violence among social networks of Tanzanian men.

Journal Article PloS one · January 2020 Despite calls to engage men in HIV and intimate partner violence (IPV) prevention efforts, effective approaches to reach and engage men in low-resource, high-HIV prevalence settings are limited. We identified and engaged social networks of mostly young men ... Full text Cite

Engaging Young Men as Community Health Leaders in an STI and Intimate Partner Violence Prevention Trial in Dar es Salaam, Tanzania.

Journal Article Global social welfare : research, policy & practice · December 2019 BackgroundThis article presents lessons learned from a microfinance and health intervention for young men designed to prevent sexually transmitted infections (STI) and intimate partner violence (IPV) in Dar es Salaam, Tanzania. We describe the dif ... Full text Cite

Women's perspectives on ImpACT: a coping intervention to address sexual trauma and improve HIV care engagement in Cape Town, South Africa.

Journal Article AIDS care · November 2019 HIV-infected women who have experienced sexual violence face unique challenges in their HIV care engagement and adherence to antiretroviral medications (ARVs). Improving AIDS Care after Trauma (ImpACT) is a brief counseling intervention aimed at reducing t ... Full text Cite

Microfinance and health interventions: Factors influencing loan repayment success with young men in Dar es Salaam, Tanzania.

Journal Article Global public health · February 2019 Poverty is associated with numerous poor health outcomes. Youth unemployment in Tanzania is approximately 13.7%, and concentrates in urban areas. These youth lack relevant job skills and access to financial capital. Microfinance continues to be implemented ... Full text Cite

Structural Network Position and Performance of Health Leaders Within an HIV Prevention Trial.

Journal Article AIDS and behavior · September 2018 Featured Publication The effectiveness of peer leaders in promoting health may depend on the position they occupy within their social networks. Using sociocentric (whole network) and behavioral data from the intervention arm of a cluster-randomized HIV prevention trial in Dar ... Full text Cite

eHealth to Enhance Treatment Adherence Among Youth Living with HIV.

Journal Article Current HIV/AIDS reports · August 2018 Featured Publication Purpose of reviewMultiple reviews have examined eHealth/mHealth interventions to address treatment adherence, including those focusing on youth living with HIV (YLWH). This review synthesizes results of prior reviews and recent studies (last 5 yea ... Full text Cite

Perpetration and Victimization of Intimate Partner Violence Among Young Men and Women in Dar es Salaam, Tanzania.

Journal Article Journal of interpersonal violence · August 2018 We describe and compare the baseline rates of victimization and perpetration of three forms of intimate partner violence (IPV)-psychological, physical, and sexual-among sexually active men ( n = 1,113) and women ( n = 226) enrolled in an ongoing cluster-ra ... Full text Cite

Associations Between Peer Network Gender Norms and the Perpetration of Intimate Partner Violence Among Urban Tanzanian Men: a Multilevel Analysis.

Journal Article Prevention science : the official journal of the Society for Prevention Research · May 2018 Featured Publication Male perpetration of intimate partner violence (IPV) against women in sub-Saharan Africa is widespread. Theory and empirical evidence suggest peer networks may play an important role in shaping IPV perpetration, though research on this topic in the region ... Full text Cite

Peer network influence on intimate partner violence perpetration among urban Tanzanian men.

Journal Article Culture, health & sexuality · April 2018 Male perpetration of intimate partner violence (IPV) against women in Tanzania is widespread. Theory and empirical evidence suggest peer networks may play an important role in shaping IPV perpetration, although research on this topic in sub-Saharan Africa ... Full text Cite

Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa.

Journal Article AIDS and behavior · March 2018 Featured Publication Improving AIDS Care after Trauma (ImpACT), a coping intervention for HIV-infected women with sexual abuse histories, was evaluated for feasibility and potential efficacy in a public clinic in Cape Town, South Africa. Sixty-four participants were enrolled p ... Full text Cite

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept.

Journal Article AIDS Behav · February 2018 Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH ... Full text Link to item Cite

Social Network Influence on HIV Testing Among Urban Men in Tanzania.

Journal Article AIDS and behavior · April 2017 Featured Publication Men in sub-Saharan Africa have low HIV testing rates. Social networks exert an important influence on men's HIV-related behavior. We examined associations between network factors and HIV testing among men in Dar es Salaam, Tanzania. Data are from the basel ... Full text Cite

Leveraging strong social ties among young men in Dar es Salaam: A pilot intervention of microfinance and peer leadership for HIV and gender-based violence prevention.

Journal Article Global public health · December 2016 Gender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion inte ... Full text Cite

Comparing Perceptions with Actual Reports of Close Friend's HIV Testing Behavior Among Urban Tanzanian Men.

Journal Article AIDS and behavior · September 2016 Featured Publication Men have lower rates of HIV testing and higher rates of AIDS-related mortality compared to women in sub-Saharan Africa. To assess whether there is an opportunity to increase men's uptake of testing by correcting misperceptions about testing norms, we compa ... Full text Cite

Evidence of social network influence on multiple HIV risk behaviors and normative beliefs among young Tanzanian men.

Journal Article Social science & medicine (1982) · March 2016 Featured Publication Research on network-level influences on HIV risk behaviors among young men in sub-Saharan Africa is severely lacking. One significant gap in the literature that may provide direction for future research with this population is understanding the degree to w ... Full text Cite

Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam.

Journal Article BMC public health · February 2016 BackgroundIntimate partner violence (IPV) and sexually transmitted infections (STIs), including HIV, remain important public health problems with devastating health effects for men and women in sub-Saharan Africa. There have been calls to engage m ... Full text Cite

Global Health Diplomacy, Monitoring & Evaluation, and the Importance of Quality Assurance & Control: Findings from NIMH Project Accept (HPTN 043): A Phase III Randomized Controlled Trial of Community Mobilization, Mobile Testing, Same-Day Results, and Post-Test Support for HIV in Sub-Saharan Africa and Thailand.

Journal Article PloS one · January 2016 BackgroundProvision and scale-up of high quality, evidence-based services is essential for successful international HIV prevention interventions in order to generate and maintain intervention uptake, study integrity and participant trust, from bot ... Full text Cite

The role of relationship types on condom use among urban men with concurrent partners in Ghana and Tanzania.

Journal Article AIDS care · January 2015 Multiple concurrent partnerships are hypothesized to be important drivers of HIV transmission. Despite the demonstrated importance of relationship type (i.e., wife, girlfriend, casual partner, sex worker) on condom use, research on concurrency has not exam ... Full text Cite

Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial.

Journal Article The Lancet. Global health · May 2014 BackgroundAlthough several interventions have shown reduced HIV incidence in clinical trials, the community-level effect of effective interventions on the epidemic when scaled up is unknown. We investigated whether a multicomponent, multilevel soc ... Full text Cite

NIMH Project Accept (HPTN 043): results from in-depth interviews with a longitudinal cohort of community members.

Journal Article PLoS One · 2014 INTRODUCTION: NIMH Project Accept (HPTN 043) is a community- randomized trial to test the safety and efficacy of a community-level intervention designed to increase testing and lower HIV incidence in Tanzania, Zimbabwe, South Africa and Thailand. The evalu ... Full text Link to item Cite

NIMH Project Accept (HPTN 043) HIV/AIDS community mobilization (CM) to promote mobile HIV voluntary counseling and testing (MVCT) in rural communities in Northern Thailand: modifications by experience.

Journal Article AIDS and behavior · July 2012 Project Accept is a RCT designed to test the efficacy of community mobilization (CM), mobile voluntary counseling and testing (MVCT), and post-test support services (PTSS) in reducing HIV incidence in three African countries and Thailand. The intervention ... Full text Cite

Health diplomacy and the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: evaluating findings from Project Accept (HPTN 043).

Journal Article BMC public health · June 2012 BackgroundStudy-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants ... Full text Cite

Community-based intervention to increase HIV testing and case detection in people aged 16-32 years in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): a randomised study.

Journal Article The Lancet. Infectious diseases · July 2011 BackgroundIn developing countries, most people infected with HIV do not know their infection status. We aimed to assess whether HIV testing could be increased by combination of community mobilisation, mobile community-based voluntary counselling a ... Full text Cite