TY - JOUR
T1 - A Cluster-Randomized Controlled Trial of an Economic Strengthening Intervention to Enhance Antiretroviral Therapy Adherence among Adolescents Living with HIV.
AU - Kizito, Samuel
AU - Namuwonge, Flavia
AU - Nabayinda, Josephine
AU - Nalwanga, Damalie
AU - Najjuuko, Claire
AU - Nabunya, Proscovia
AU - Atwebembere, Raymond
AU - Namuyaba, Olive Imelda
AU - Mukasa, Miriam
AU - Ssewamala, Fred M.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024/5
Y1 - 2024/5
N2 - We examined the impact of an economic empowerment intervention on ART adherence among ALHIV. We used data from 455 ALHIV, randomized into intervention, n = 111, and control n = 344. ALHIV were aged 12–16 and recruited from 39 clinics in Uganda between January 2013 and December 2015. The intervention comprised a long-term child development account (CDA), micro-enterprise workshops, and educational sessions. Adherence was measured using unannounced pill counts. We used mixed-effects logistic regression analysis to examine the effect of the intervention on ART adherence. The mean age was 12.6 years. Despite observing non-significant group main effects, we found significant group-by-time interaction effects χ2(5) = 45.41, p < 0.001. Pairwise comparisons showed that compared to the control group, participants who received the intervention had significantly higher adherence at visit four, OR = 1.52 (95% CI: 1.07–2.18), p = 0.020; visit five, OR = 1.59 (95% CI: 1.06–2.38), p = 0.026; and visit six, OR = 1.94 (95% CI: 1.24–3.04), p = 0.004. Efforts to support ALHIV to live longer and healthier lives should incorporate components addressing poverty. However, declining adherence raises concerns over ALHIV’s long-term well-being. The trial was registered at ClinicalTrials.gov, registration number NCT01790373, with a primary outcome of adherence to HIV treatment.
AB - We examined the impact of an economic empowerment intervention on ART adherence among ALHIV. We used data from 455 ALHIV, randomized into intervention, n = 111, and control n = 344. ALHIV were aged 12–16 and recruited from 39 clinics in Uganda between January 2013 and December 2015. The intervention comprised a long-term child development account (CDA), micro-enterprise workshops, and educational sessions. Adherence was measured using unannounced pill counts. We used mixed-effects logistic regression analysis to examine the effect of the intervention on ART adherence. The mean age was 12.6 years. Despite observing non-significant group main effects, we found significant group-by-time interaction effects χ2(5) = 45.41, p < 0.001. Pairwise comparisons showed that compared to the control group, participants who received the intervention had significantly higher adherence at visit four, OR = 1.52 (95% CI: 1.07–2.18), p = 0.020; visit five, OR = 1.59 (95% CI: 1.06–2.38), p = 0.026; and visit six, OR = 1.94 (95% CI: 1.24–3.04), p = 0.004. Efforts to support ALHIV to live longer and healthier lives should incorporate components addressing poverty. However, declining adherence raises concerns over ALHIV’s long-term well-being. The trial was registered at ClinicalTrials.gov, registration number NCT01790373, with a primary outcome of adherence to HIV treatment.
KW - Adolescents living with HIV (ALHIV)
KW - Antiretroviral therapy adherence
KW - Economic strengthening
KW - People living with HIV (PLHIV)
KW - Suubi intervention
UR - https://www.scopus.com/pages/publications/85182413084
U2 - 10.1007/s10461-024-04268-4
DO - 10.1007/s10461-024-04268-4
M3 - Article
C2 - 38231361
AN - SCOPUS:85182413084
SN - 1090-7165
VL - 28
SP - 1570
EP - 1580
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 5
ER -