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 language | English (US) |
|---|---|
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | AIDS and Behavior |
| DOIs | |
| State | Accepted/In press - May 30 2018 |
Fingerprint
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
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 journal › Article
}
TY - JOUR
T1 - Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda
AU - Bermudez, Laura Gauer
AU - Ssewamala, Fred M.
AU - Neilands, Torsten B.
AU - Lu, Lily
AU - Mayo-Wilson, Larissa Jennings
AU - Nakigozi, Gertrude
AU - Mellins, Claude A.
AU - McKay, Mary
AU - Mukasa, Miriam
PY - 2018/5/30
Y1 - 2018/5/30
N2 - 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.
AB - 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.
KW - Adolescents
KW - ART
KW - Assets
KW - Economic empowerment
KW - HIV
KW - Savings-led intervention
KW - SUUBI
UR - http://www.scopus.com/inward/record.url?scp=85047793636&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047793636&partnerID=8YFLogxK
U2 - 10.1007/s10461-018-2173-7
DO - 10.1007/s10461-018-2173-7
M3 - Article
C2 - 29846836
AN - SCOPUS:85047793636
SP - 1
EP - 10
JO - AIDS and Behavior
JF - AIDS and Behavior
SN - 1090-7165
ER -