Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda

Laura Gauer Bermudez, Fred M. Ssewamala, Torsten B. Neilands, Lily Lu, Larissa Jennings Mayo-Wilson, Gertrude Nakigozi, Claude A. Mellins, Mary McKay, Miriam Mukasa

Research output: Contribution to journalArticle

Abstract

To assess the effect of a savings-led economic empowerment intervention on viral suppression among adolescents living with HIV. Using data from Suubi + Adherence, a longitudinal, cluster randomized trial in southern Uganda (2012–2017), we examine the effect of the intervention on HIV RNA viral load, dichotomized between undetectable (< 40 copies/ml) and detectable (≥ 40 copies/ml). Cluster-adjusted comparisons of means and proportions were used to descriptively analyze changes in viral load between study arms while multi-level modelling was used to estimate treatment efficacy after adjusting for fixed and random effects. At 24-months post intervention initiation, the proportion of virally suppressed participants in the intervention cohort increased tenfold (ΔT2−T0 = + 10.0, p = 0.001) relative to the control group (ΔT2−T0 = + 1.1, p = 0.733). In adjusted mixed models, simple main effects tests identified significantly lower odds of intervention adolescents having a detectable viral load at both 12- and 24-months. Interventions addressing economic insecurity have the potential to bolster health outcomes, such as HIV viral suppression, by improving ART adherence among vulnerable adolescents living in low-resource environments. Further research and policy dialogue on the intersections of financial security and HIV treatment are warranted.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalAIDS and Behavior
DOIs
StateAccepted/In press - May 30 2018

Fingerprint

Uganda
Viral Load
Economics
HIV
RNA
Control Groups
Health
Research
Therapeutics

Keywords

  • Adolescents
  • ART
  • Assets
  • Economic empowerment
  • HIV
  • Savings-led intervention
  • SUUBI

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Bermudez, L. G., Ssewamala, F. M., Neilands, T. B., Lu, L., Mayo-Wilson, L. J., Nakigozi, G., ... Mukasa, M. (Accepted/In press). Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda. AIDS and Behavior, 1-10. https://doi.org/10.1007/s10461-018-2173-7

Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda. / Bermudez, Laura Gauer; Ssewamala, Fred M.; Neilands, Torsten B.; Lu, Lily; Mayo-Wilson, Larissa Jennings; Nakigozi, Gertrude; Mellins, Claude A.; McKay, Mary; Mukasa, Miriam.

In: AIDS and Behavior, 30.05.2018, p. 1-10.

Research output: Contribution to journalArticle

Bermudez, LG, Ssewamala, FM, Neilands, TB, Lu, L, Mayo-Wilson, LJ, Nakigozi, G, Mellins, CA, McKay, M & Mukasa, M 2018, 'Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda', AIDS and Behavior, pp. 1-10. https://doi.org/10.1007/s10461-018-2173-7
Bermudez, Laura Gauer ; Ssewamala, Fred M. ; Neilands, Torsten B. ; Lu, Lily ; Mayo-Wilson, Larissa Jennings ; Nakigozi, Gertrude ; Mellins, Claude A. ; McKay, Mary ; Mukasa, Miriam. / Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda. In: AIDS and Behavior. 2018 ; pp. 1-10.
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