12 results on '"MUKASA"'
Search Results
2. Suubi+Adherence-Round 2: A study protocol to examine the longitudinal HIV treatment adherence among youth living with HIV transitioning into young adulthood in Southern Uganda
- Author
-
Ssewamala, Fred M., Sensoy Bahar, Ozge, Nabunya, Proscovia, Thames, April D., Neilands, Torsten B., Damulira, Christopher, Mukasa, Barbara, Brathwaite, Rachel, Mellins, Claude, Santelli, John, Brown, Derek, Guo, Shenyang, Namatovu, Phionah, Kiyingi, Joshua, Namuwonge, Flavia, and McKay, Mary M.
- Published
- 2021
- Full Text
- View/download PDF
3. Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda
- Author
-
Bermudez, Laura Gauer, Ssewamala, Fred M., Neilands, Torsten B., Lu, Lily, Jennings, Larissa, Nakigozi, Gertrude, Mellins, Claude A., McKay, Mary, and Mukasa, Miriam
- Published
- 2018
- Full Text
- View/download PDF
4. Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda
- Author
-
Ssewamala, Fred M., Bermudez, Laura Gauer, Neilands, Torsten B., Mellins, Claude A., McKay, Mary M., Garfinkel, Irv, Sensoy Bahar, Ozge, Nakigozi, Gertrude, Mukasa, Miriam, Stark, Lindsay, Damulira, Christopher, Nattabi, Jennifer, and Kivumbi, Apollo
- Published
- 2018
- Full Text
- View/download PDF
5. The efficacy and cost‐effectiveness of a family‐based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV: results from a Cluster Randomized Controlled Trial in southern Uganda
- Author
-
Mary McKay, Yesim Tozan, Claude A. Mellins, Abel Mwebembezi, Ozge Sensoy Bahar, Proscovia Nabunya, Flavia Namuwonge, Sicong Sun, Fred M. Ssewamala, Torsten B. Neilands, Barbara Mukasa, Ariadna Capasso, Christopher Damulira, and Gertrude Nakigozi
- Subjects
Male ,Cost‐effectiveness analysis ,Adolescent ,Cost effectiveness ,Cost-Benefit Analysis ,media_common.quotation_subject ,Psychological intervention ,HIV Infections ,Medication Adherence ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intervention (counseling) ,Environmental health ,Humans ,Medicine ,Uganda ,adolescents ,030212 general & internal medicine ,Empowerment ,Poverty ,Research Articles ,economic empowerment ,media_common ,030505 public health ,business.industry ,savings‐led intervention ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,HIV ,Cost-effectiveness analysis ,Viral Load ,Infectious Diseases ,SUUBI ,Female ,0305 other medical science ,business ,Viral load ,ART ,Research Article - Abstract
Introduction Evidence from low‐resource settings indicates that economic insecurity is a major barrier to HIV treatment adherence. Economic empowerment (EE) interventions have the potential to improve adherence outcomes among adolescents living with HIV (ALWHIV) by mitigating the effects of poverty. This study aims to assess the efficacy and cost‐effectiveness of a savings‐led family‐based EE intervention, Suubi + Adherence, aimed at improving antiretroviral therapy (ART) adherence outcomes ALWHIV in Uganda. Methods Adolescents (mean age 12 years at enrolment; 56% female) receiving ART for HIV at 39 health centres were randomized to Suubi + Adherence intervention (n = 358) or bolstered standard of care (BSOC; n = 344). A difference‐in‐differences analysis was employed to assess the change in the proportion of virally suppressed adolescents (HIV RNA viral load
- Published
- 2021
6. Integrating a Mentorship Component in Programming for Care and Support of AIDS-Orphaned and Vulnerable Children: Lessons from the Suubi and Bridges Programs in Sub-Saharan Africa
- Author
-
Ssewamala, Fred M., Nabunya, Proscovia, Mukasa, N. Miriam, Ilic, Vilma, and Nattabi, Jennifer
- Published
- 2014
- Full Text
- View/download PDF
7. Suubi+Adherence-Round 2: A study protocol to examine the longitudinal HIV treatment adherence among youth living with HIV transitioning into young adulthood in Southern Uganda
- Author
-
Phionah Namatovu, Shenyang Guo, Rachel Brathwaite, Christopher Damulira, Mary McKay, John S. Santelli, Derek S. Brown, Ozge Sensoy Bahar, Flavia Namuwonge, Torsten B. Neilands, Joshua Kiyingi, Barbara Mukasa, Fred M. Ssewamala, April D. Thames, Proscovia Nabunya, and Claude A. Mellins
- Subjects
Gerontology ,Adult ,sub-Saharan Africa ,medicine.medical_specialty ,Adolescent ,Cost effectiveness ,Adolescent Health ,HIV Infections ,Medication Adherence ,03 medical and health sciences ,Young Adult ,Study Protocol ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Intervention (counseling) ,Medicine ,Humans ,Uganda ,030212 general & internal medicine ,Young adult ,economic empowerment ,030505 public health ,business.industry ,lcsh:Public aspects of medicine ,Public health ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Youth living with HIV ,cohort ,medicine.disease ,Mental health ,Treatment Adherence and Compliance ,HIV/AIDS ,0305 other medical science ,business ,Neurocognitive ,Adolescent health - Abstract
BackgroundYouth living with HIV (YLHIV) in Sub-Saharan African (SSA) are less likely to adhere to antiretroviral therapy (ART) and other health-related regimens. As a consequence, YLHIV are not only at risk for health problems and mental health comorbidities, but are also at risk for cognitive deficits, including in areas of memory and executive functioning. The Suubi+Adherence study followed 702 adolescents (10-16 years of age) receiving bolstered standard of care and a family economic empowerment intervention comprising an incentivized youth financial savings account (YSA) augmented with financial literacy training (FLT) and peer mentorship. The study findings pointed to superior short-term viral suppression and positive adolescent health and mental health functioning among participants receiving the intervention. The original group of adolescents who received Suubi+Adherence are now transitioning into young adulthood. This paper presents a protocol for the follow-up phase titled Suubi+Adherence Round 2.MethodsThe original cohort in Suubi+Adherence will be tracked for an additional five years (2020-2025). Specifically, the long term follow-up will allow to: 1) ascertain the extent to which the short term outcomes identified in the first 6 years of the intervention are maintained as the same group transitions through young adulthood; and 2) address new scientific questions regarding ART adherence; HIV care engagement; protective health behaviors; and the potential of FEE to mitigate the development of HIV-associated neurocognitive disorders in YLHIV. Additionally, the team examines the potential mechanisms through which the observed long-term outcomes happen. Moreover, the Suubi+Adherence-Round 2 adds a qualitative component and extends the cost effectiveness component.DiscussionGuided by asset and human development theories, Suubi+Adherence-R2 will build on the recently concluded Suubi+Adherence study to conduct one of the largest and longest running studies of YLHIV in SSA as they transition into young adulthood. The study will address new scientific questions regarding long-term ART adherence, HIV care engagement, protective health behaviors, and the potential of FEE to mitigate the development of HIV-associated neurocognitive disorders in YLHIV. The findings may inform efforts to improve HIV care among Uganda’s YLHIV, with potential replicability in other low-resource countries.Trial registrationClinicalTrials.gov, ID:NCT01790373
- Published
- 2021
- Full Text
- View/download PDF
8. The efficacy and cost‐effectiveness of a family‐based economic empowerment intervention (Suubi + Adherence) on suppression of HIV viral loads among adolescents living with HIV: results from a Cluster Randomized Controlled Trial in southern Uganda
- Author
-
Tozan, Yesim, Capasso, Ariadna, Sun, Sicong, Neilands, Torsten B, Damulira, Christopher, Namuwonge, Flavia, Nakigozi, Gertrude, Mwebembezi, Abel, Mukasa, Barbara, Sensoy Bahar, Ozge, Nabunya, Proscovia, Mellins, Claude A, McKay, Mary M, and Ssewamala, Fred M
- Subjects
CLUSTER randomized controlled trials ,TEENAGERS ,VIRAL load ,ADOLESCENT health ,HIV ,SELF-efficacy ,COST effectiveness - Abstract
Introduction: Evidence from low‐resource settings indicates that economic insecurity is a major barrier to HIV treatment adherence. Economic empowerment (EE) interventions have the potential to improve adherence outcomes among adolescents living with HIV (ALWHIV) by mitigating the effects of poverty. This study aims to assess the efficacy and cost‐effectiveness of a savings‐led family‐based EE intervention, Suubi + Adherence, aimed at improving antiretroviral therapy (ART) adherence outcomes ALWHIV in Uganda. Methods: Adolescents (mean age 12 years at enrolment; 56% female) receiving ART for HIV at 39 health centres were randomized to Suubi + Adherence intervention (n = 358) or bolstered standard of care (BSOC; n = 344). A difference‐in‐differences analysis was employed to assess the change in the proportion of virally suppressed adolescents (HIV RNA viral load <40 copies/mL) over 24 months. The cost‐effectiveness analysis examined how much the intervention cost to virally suppress one additional adolescent relative to BSOC from the healthcare provider perspective. Results: At 24 months, the intervention was associated with an 8.85‐percentage point [95% confidence interval (CI) 0.80 to 16.90 percentage points] increase in the proportion of virally suppressed adolescents between the study arms (p = 0.032). Per‐participant costs were US$177 and US$263 for the BSOC and intervention groups respectively. The incremental cost of virally suppressing one additional adolescent was estimated at US$970 [95% CI, US$508 to 10,725] over two years. Conclusions: Our results support the integration of family‐based EE interventions into adherence‐support strategies as part of routine HIV care in low‐resource settings to address the underlying economic drivers of poor ART adherence among ALWHIV. Moreover, per‐participant costs to achieve viral suppression do not seem prohibitive compared to other community‐based adherence interventions targeted at ALWHIV in low‐resource settings. Further research on combination interventions at the nexus of economic security and HIV treatment and care is needed to inform the development of feasible and scalable HIV policies and programmes. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
9. Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda
- Author
-
Miriam N. Mukasa, Torsten B. Neilands, Jennifer Nattabi, Irv Garfinkel, Claude A. Mellins, Mary McKay, Ozge Sensoy Bahar, Laura Gauer Bermudez, Apollo Kivumbi, Christopher Damulira, Fred M. Ssewamala, Lindsay Stark, and Gertrude Nakigozi
- Subjects
Counseling ,Gerontology ,Family strengthening ,Family support ,Economic capital ,Psychological intervention ,HIV Infections ,0302 clinical medicine ,Pregnancy ,Medicine ,Uganda ,Prospective Studies ,030212 general & internal medicine ,Empowerment ,media_common ,Assets ,Schools ,lcsh:Public aspects of medicine ,Youth development ,Economic empowerment ,Mental Health ,Costs and Cost Analysis ,Female ,Health education ,0305 other medical science ,Positive Youth Development ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,media_common.quotation_subject ,Intervention ,Health Promotion ,Teenage girls--Health and hygiene ,03 medical and health sciences ,Risk-Taking ,Humans ,030505 public health ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,lcsh:RA1-1270 ,Combination interventions ,Mental health ,HIV infections—Prevention ,Teenage girls--Mental health ,Teenage girls--Economic conditions ,Power, Psychological ,business ,Adolescent girls ,Program Evaluation - Abstract
Background Asset-based economic empowerment interventions, which take an integrated approach to building human, social, and economic capital, have shown promise in their ability to reduce HIV risk for young people, including adolescent girls, in sub-Saharan Africa. Similarly, community and family strengthening interventions have proven beneficial in addressing mental health and behavioral challenges of adolescents transitioning to adulthood. Yet, few programs aimed at addressing sexual risk have applied combination interventions to address economic stability and mental health within the traditional framework of health education and HIV counseling/testing. This paper describes a study protocol for a 5-year, NIMH-funded, cluster randomized-controlled trial to evaluate a combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. The intervention, titled Suubi4Her, combines savings-led economic empowerment through youth development accounts (YDA) with an innovative family strengthening component delivered via Multiple Family Groups (MFG). Methods Suubi4Her will be evaluated via a three-arm cluster randomized-controlled trial design (YDA only, YDA + MFG, Usual Care) in 42 secondary schools in the Central region of Uganda, targeting a total of 1260 girls (ages 15–17 at enrollment). Assessments will occur at baseline, 12, 24, and 36 months. This study addresses two primary outcomes: 1) change in HIV risk behavior and 2) change in mental health functioning. Secondary exploratory outcomes include HIV and STI incidence, pregnancy, educational attainment, financial savings behavior, gender attitudes, and self-esteem. For potential scale-up, cost effectiveness analysis will be employed to compare the relative costs and outcomes associated with each study arm. Conclusions Suubi4Her will be one of the first prospective studies to examine the impact and cost of a combination intervention integrating economic and social components to reduce known HIV risk factors and improve mental health functioning among adolescent girls, while concurrently exploring mental health as a mediator in HIV risk reduction. The findings will illuminate the pathways that connect economic needs, mental health, family support, and HIV risk. If successful, the results will promote holistic HIV prevention strategies to reduce risk among adolescent girls in Uganda and potentially the broader sub-Saharan Africa region. Trial registration Clinical Trials NCT03307226 (Registered: 10/11/17).
- Published
- 2018
10. Suubi + Adherence4Youth: a study protocol to optimize the Suubi Intervention for Adherence to HIV treatment for youth living with HIV in Uganda
- Author
-
Fred M. Ssewamala, John A. Sauceda, Rachel Brathwaite, Torsten B. Neilands, Proscovia Nabunya, Derek Brown, Ozge Sensoy Bahar, Flavia Namuwonge, Noeline Nakasujja, Allan Mugarura, Abel Mwebembezi, Portia Nartey, Barbara Mukasa, and Marya Gwadz
- Subjects
Optimization ,Suubi + adherence ,Youth ,Economic empowerment ,Viral suppression ,Adherence ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Suubi is an evidenced based multi-component intervention that targets psychosocial and economic hardships to improve ART adherence, viral suppression, mental health, family financial stability, and family cohesion for adolescents living with HIV (ALHIV) in Uganda. Suubi was originally tested as a combined package of four components: 1) Financial Literacy Training; 2) incentivized matched Youth Savings Accounts with income-generating activities; 3) a manualized and visual-based intervention for ART adherence and stigma reduction; and 4) engagement with HIV treatment-experienced role models. However, it is unknown if each component in Suubi had a positive effect, how the components interacted, or if fewer components could have produced equivalent effects. Hence, the overall goal of this new study is to identify the most impactful and sustainable economic and psychosocial components across 48 health clinics in Uganda. Methods A total of 576 ALHIV (aged 11–17 years at enrollment) will be recruited from 48 clinics and each clinic will be randomized to one of 16 study conditions. Each condition represents every possible combination of the 4 components noted above. Assessments will be conducted at baseline, 12, 24, 36 and 48- months post-intervention initiation. Using the multi-phase optimization strategy (MOST), we will identify the optimal combination of components and associated costs for viral suppression, as well as test key mediators and moderators of the component-viral suppression relationship. Discussion The study is a shift in the paradigm of research to use new thinking to build/un-pack highly efficacious interventions that lead to new scientific knowledge in terms of understanding what drives an intervention’s success and how to iterate on them in ways that are more efficient, affordable and scalable. The study advances intervention science for HIV care outcomes globally. Trial Registration This project was registered at clinicaltrials.gov (NCT05600621) on October, 31, 2022. https://clinicaltrials.gov/ct2/show/NCT05600621
- Published
- 2023
- Full Text
- View/download PDF
11. Suubi+Adherence-Round 2: A study protocol to examine the longitudinal HIV treatment adherence among youth living with HIV transitioning into young adulthood in Southern Uganda
- Author
-
Fred M. Ssewamala, Ozge Sensoy Bahar, Proscovia Nabunya, April D. Thames, Torsten B. Neilands, Christopher Damulira, Barbara Mukasa, Rachel Brathwaite, Claude Mellins, John Santelli, Derek Brown, Shenyang Guo, Phionah Namatovu, Joshua Kiyingi, Flavia Namuwonge, and Mary M. McKay
- Subjects
Youth living with HIV ,cohort ,economic empowerment ,sub-Saharan Africa ,Uganda ,HIV/AIDS ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Youth living with HIV (YLHIV) in Sub-Saharan African (SSA) are less likely to adhere to antiretroviral therapy (ART) and other health-related regimens. As a consequence, YLHIV are not only at risk for health problems and mental health comorbidities, but are also at risk for cognitive deficits, including in areas of memory and executive functioning. The Suubi+Adherence study followed 702 adolescents (10-16 years of age) receiving bolstered standard of care and a family economic empowerment intervention comprising an incentivized youth financial savings account (YSA) augmented with financial literacy training (FLT) and peer mentorship. The study findings pointed to superior short-term viral suppression and positive adolescent health and mental health functioning among participants receiving the intervention. The original group of adolescents who received Suubi+Adherence are now transitioning into young adulthood. This paper presents a protocol for the follow-up phase titled Suubi+Adherence Round 2. Methods The original cohort in Suubi+Adherence will be tracked for an additional five years (2020-2025). Specifically, the long term follow-up will allow to: 1) ascertain the extent to which the short term outcomes identified in the first 6 years of the intervention are maintained as the same group transitions through young adulthood; and 2) address new scientific questions regarding ART adherence; HIV care engagement; protective health behaviors; and the potential of FEE to mitigate the development of HIV-associated neurocognitive disorders in YLHIV. Additionally, the team examines the potential mechanisms through which the observed long-term outcomes happen. Moreover, the Suubi+Adherence-Round 2 adds a qualitative component and extends the cost effectiveness component. Discussion Guided by asset and human development theories, Suubi+Adherence-R2 will build on the recently concluded Suubi+Adherence study to conduct one of the largest and longest running studies of YLHIV in SSA as they transition into young adulthood. The study will address new scientific questions regarding long-term ART adherence, HIV care engagement, protective health behaviors, and the potential of FEE to mitigate the development of HIV-associated neurocognitive disorders in YLHIV. The findings may inform efforts to improve HIV care among Uganda’s YLHIV, with potential replicability in other low-resource countries. Trial registration ClinicalTrials.gov , ID: NCT01790373
- Published
- 2021
- Full Text
- View/download PDF
12. Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda
- Author
-
Fred M. Ssewamala, Laura Gauer Bermudez, Torsten B. Neilands, Claude A. Mellins, Mary M. McKay, Irv Garfinkel, Ozge Sensoy Bahar, Gertrude Nakigozi, Miriam Mukasa, Lindsay Stark, Christopher Damulira, Jennifer Nattabi, and Apollo Kivumbi
- Subjects
HIV ,Adolescent girls ,Assets ,Economic empowerment ,Family strengthening ,Combination interventions ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Asset-based economic empowerment interventions, which take an integrated approach to building human, social, and economic capital, have shown promise in their ability to reduce HIV risk for young people, including adolescent girls, in sub-Saharan Africa. Similarly, community and family strengthening interventions have proven beneficial in addressing mental health and behavioral challenges of adolescents transitioning to adulthood. Yet, few programs aimed at addressing sexual risk have applied combination interventions to address economic stability and mental health within the traditional framework of health education and HIV counseling/testing. This paper describes a study protocol for a 5-year, NIMH-funded, cluster randomized-controlled trial to evaluate a combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. The intervention, titled Suubi4Her, combines savings-led economic empowerment through youth development accounts (YDA) with an innovative family strengthening component delivered via Multiple Family Groups (MFG). Methods Suubi4Her will be evaluated via a three-arm cluster randomized-controlled trial design (YDA only, YDA + MFG, Usual Care) in 42 secondary schools in the Central region of Uganda, targeting a total of 1260 girls (ages 15–17 at enrollment). Assessments will occur at baseline, 12, 24, and 36 months. This study addresses two primary outcomes: 1) change in HIV risk behavior and 2) change in mental health functioning. Secondary exploratory outcomes include HIV and STI incidence, pregnancy, educational attainment, financial savings behavior, gender attitudes, and self-esteem. For potential scale-up, cost effectiveness analysis will be employed to compare the relative costs and outcomes associated with each study arm. Conclusions Suubi4Her will be one of the first prospective studies to examine the impact and cost of a combination intervention integrating economic and social components to reduce known HIV risk factors and improve mental health functioning among adolescent girls, while concurrently exploring mental health as a mediator in HIV risk reduction. The findings will illuminate the pathways that connect economic needs, mental health, family support, and HIV risk. If successful, the results will promote holistic HIV prevention strategies to reduce risk among adolescent girls in Uganda and potentially the broader sub-Saharan Africa region. Trial registration Clinical Trials NCT03307226 (Registered: 10/11/17).
- Published
- 2018
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.