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

AIDS and Behavior
Laura Gauer BermudezMiriam Mukasa

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. Fu...Continue Reading

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Citations

Jul 6, 2019·AIDS·Deborah KacanekUNKNOWN Pediatric HIV/AIDS Cohort Study
Feb 2, 2019·The International Journal of Health Planning and Management·Miriam N MukasaChristopher Damulira
Jun 12, 2020·Therapeutic Advances in Infectious Disease·Caroline FosterSarah Fidler
Jan 6, 2022·Journal of the International Association of Providers of AIDS Care·Jean Népomuscène NshimyumuremyiDale A Barnhart

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