The Long-term (5-year) Impact of a Family Economic Empowerment Intervention on Adolescents Living with HIV in Uganda: Analysis of Longitudinal Data from a Cluster Randomized Controlled Trial from the Suubi+Adherence Study (2012-2018).
Adolescents living with HIV
Economic interventions
Sub-saharan Africa
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
accepted:
18
02
2022
pubmed:
17
4
2022
medline:
17
9
2022
entrez:
16
4
2022
Statut:
ppublish
Résumé
150/150 words.We examined the 5-year impact of an economic empowerment (EE) intervention on: adherence, viral suppression, sexual risk-taking intentions (primary); and physical health, educational and economic (secondary) outcomes among adolescents living with HIV in Uganda. The Suubi + Adherence study (2012-2018) randomized clinics to: (1) Control group, n = 19 clinics, n = 344 participants; (2) intervention group which received matched savings accounts, mentorship, financial management and, business development training, n = 20 clinics, n = 358 participants. Participants completed post-baseline assessments at 12-, 24-, 36-, and 48-months. No significant differences in viral load, sexual risk-intentions and physical health perception were observed. The intervention group had better adherence (at 24-months) (Contrast=-0.28; 95% CI: -0.55, -0.004), higher school enrolment (OR = 2.18; 95% CI:1.30, 3.66); reported savings OR = 2.03 (1.29, 3.18) and higher savings (Contrast = 0.40; 95% CI:0.10, 0.70) than controls at 48-months. The EE intervention was efficacious in improving adherence, school enrolment, and economic outcomes creating opportunities for improved overall health among adolescents living with HIV.
Identifiants
pubmed: 35429307
doi: 10.1007/s10461-022-03637-1
pii: 10.1007/s10461-022-03637-1
pmc: PMC9474691
mid: NIHMS1799594
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
3337-3344Subventions
Organisme : NIMHD NIH HHS
ID : T37 MD014218
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD074949
Pays : United States
Organisme : NIMH NIH HHS
ID : R25 MH118935
Pays : United States
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : 1R01HD074949-01
Organisme : NIMH NIH HHS
ID : R25 MH067127
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
UNICEF. Adolescent HIV, Prevention. HIV in adolescents: UNICEF; 2020 [Available from: https://data.unicef.org/topic/hivaids/adolescents-young-people/ .
UPHIA. UGANDA POPULATION-BASED HIV IMPACT ASSESSMENT. UPHIA 2016–2017. Uganda; 2018.
UNAIDS. Country factsheets. Uganda 2019: HIV and AIDS Estimates 2019 [Available from: https://www.unaids.org/en/regionscountries/countries/uganda .
Tuller DM, Bangsberg DR, Senkungu J, Ware NC, Emenyonu N, Weiser SD. Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav. 2010;14(4):778–84.
doi: 10.1007/s10461-009-9533-2
Au JT, Kayitenkore K, Shutes E, Karita E, Peters PJ, Tichacek A, et al. Access to adequate nutrition is a major potential obstacle to antiretroviral adherence among HIV-infected individuals in Rwanda. Aids. 2006;20(16):2116–8.
doi: 10.1097/01.aids.0000247580.16073.1b
Simoni JM, Amico KR, Pearson CR, Malow R. Strategies for promoting adherence to antiretroviral therapy: a review of the literature. Curr Infect Dis Rep. 2008;10(6):515–21.
doi: 10.1007/s11908-008-0083-y
Haberer J, Mellins C. Pediatric adherence to HIV antiretroviral therapy. Curr HIV/AIDS Rep. 2009;6(4):194–200.
doi: 10.1007/s11904-009-0026-8
Pellowski JA, Kalichman SC, Matthews KA, Adler N. A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. Am Psychol. 2013;68(4):197–209.
doi: 10.1037/a0032694
Marais BJ, Esser M, Godwin S, Rabie H, Cotton MF. Poverty and Human Immunodeficiency Virus in Children. Ann N Y Acad Sci. 2008;1136(1):21–7.
doi: 10.1196/annals.1425.012
Ssewamala FM, Byansi W, Bahar OS, Nabunya P, Neilands TB, Mellins C, et al. Suubi + Adherence study protocol: A family economic empowerment intervention addressing HIV treatment adherence for perinatally infected adolescents. Contemp Clin Trials Commun. 2019;16:100463.
doi: 10.1016/j.conctc.2019.100463
Sun S, Nabunya P, Byansi W, Bahar OS, Damulira C, Neilands TB, et al. Access and utilization of financial services among poor HIV-impacted children and families in Uganda. Child Youth Serv Rev. 2020;109:104730.
Cavazos-Rehg P, Byansi W, Xu C, Nabunya P, Sensoy Bahar O, Borodovsky J, et al. The Impact of a Family-Based Economic Intervention on the Mental Health of HIV-Infected Adolescents in Uganda: Results From Suubi + Adherence. J Adolesc health: official publication Soc Adolesc Med. 2021;68(4):742–9.
doi: 10.1016/j.jadohealth.2020.07.022
Government of Uganda. HIV and AIDS Uganda country progress report 2014. Kampala: Uganda AIDS Commission; 2014.
Uganda AIDS, Commission. National HIV and AIDS Strategic Plan 2015/2016–2019/2020. Kampala; 2015. Uganda.
Uganda AIDS, Commission. The Uganda HIV and AIDS Country Progress Report July 2015-June2016. UgandaNovember: Kampala; 2016.
Sherraden M. Assets and the poor: A new American welfare policy. New York: ME Sharpe; 1991. p. 344.
Ssewamala FM, Neilands TB, Waldfogel J, Ismayilova L. The Impact of a Comprehensive Microfinance Intervention on Depression Levels of AIDS-Orphaned Children in Uganda. J Adolesc Health. 2012;50(4):346–52.
doi: 10.1016/j.jadohealth.2011.08.008
World Health Organization. Chapter 7: Clinical guidance across the continuum of care: antiretroviral therapy. In: Consolidated guidelines on the use of antiretrovial drugs for treating and preventing HIV infection Recommendations for a public health approach. Geneva Switzerland: World Health Organization; 2013.
Shato T, Nabunya P, Byansi W, Nwaozuru U, Okumu M, Mutumba M, et al. Family Economic Empowerment, Family Social Support, and Sexual Risk-Taking Behaviors Among Adolescents Living With HIV in Uganda: The Suubi + Adherence Study. Journal of Adolescent Health. 2021;69(3):406–13.
Ross-Degnan D, Pierre-Jacques M, Zhang F, Tadeg H, Gitau L, Ntaganira J, et al. Measuring adherence to antiretroviral treatment in resource-poor settings: The clinical validity of key indicators. BMC Health Serv Res. 2010;10(1):42.
doi: 10.1186/1472-6963-10-42
Mills EJ, Nachega JB, Buchan I, Orbinski J, Attaran A, Singh S, et al. Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA. 2006;296(6):679–90.
doi: 10.1001/jama.296.6.679
de Silva TI, Peng Y, Leligdowicz A, Zaidi I, Li L, Griffin H, et al. Correlates of T-cell–mediated viral control and phenotype of CD8 + T cells in HIV-2, a naturally contained human retroviral infection. Blood. 2013;121(21):4330–9.
doi: 10.1182/blood-2012-12-472787
Ssewamala FM, Dvalishvili D, Mellins CA, Geng EH, Makumbi F, Neilands TB, et al. The long-term effects of a family based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV in southern Uganda: Findings from 5-year cluster randomized trial. PLoS ONE. 2020;15(2):e0228370.
doi: 10.1371/journal.pone.0228370
Mirowsky J, Ross CE. Education, social status, and health. Routledge; 2017.
Marmot M. Social determinants of health inequalities. The Lancet. 2005;365(9464):1099–104.
doi: 10.1016/S0140-6736(05)71146-6
Kimera E, Vindevogel S, Kintu MJ, Rubaihayo J, De Maeyer J, Reynaert D, et al. Experiences and perceptions of youth living with HIV in Western Uganda on school attendance: barriers and facilitators. BMC Public Health. 2020;20(1):79.
doi: 10.1186/s12889-020-8198-7
UNESCO. HIV & AIDS and Supportive Learning Environments. Good Policy and Practice in HIV & AIDS in Education (booklet series). Paris; 2008.
Moomba K, Van Wyk B. Social and economic barriers to adherence among patients at Livingstone General Hospital in Zambia. Afr J Prim Health Care Fam Med. 2019;11(1):e1–6.
doi: 10.4102/phcfm.v11i1.1740
Karimli L, Ssewamala FM, Neilands TB. Poor Families Striving to Save in Matched Children’s Savings Accounts: Findings from a Randomized Experimental Design in Uganda. Social Service Review. 2014;88(4):658–94.
doi: 10.1086/679256
Chowa G. Impacts of financial inclusion on youth development: Findings from the Ghana YouthSave experiment. 2015.
Ssewamala FM, Shu-Huah Wang J, Brathwaite R, Sun S, Mayo-Wilson LJ, Neilands TB, et al. Impact of a Family Economic Intervention (Bridges) on Health Functioning of Adolescents Orphaned by HIV/AIDS: A 5-Year (2012–2017) Cluster Randomized Controlled Trial in Uganda. Am J Public Health. 2021 Mar;111(3):504–513.
Hallman K. Socioeconomic disadvantage and unsafe sexual behaviors among young women and men in South Africa. 2004.
Protogerou C, Flisher AJ, Aarø LE, Mathews C. The theory of planned behaviour as a framework for predicting sexual risk behaviour in sub-Saharan African youth: A critical review. J Child Adolesc Mental Health. 2012;24(1):15–35.
doi: 10.2989/17280583.2011.621067
McCarney R, Warner J, Iliffe S, Van Haselen R, Griffin M, Fisher P. The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol. 2007;7(1):1–8.
doi: 10.1186/1471-2288-7-30
Rosenberg M, Pettifor A, Twine R, Hughes JP, Gomez-Olive FX, Wagner RG, et al. Evidence for sample selection effect and Hawthorne effect in behavioural HIV prevention trial among young women in a rural South African community. BMJ Open. 2018;8(1):e019167.
doi: 10.1136/bmjopen-2017-019167