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Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda.
- Source :
- AIDS & Behavior; Nov2018, Vol. 22 Issue 11, p3763-3772, 10p, 2 Diagrams, 3 Charts
- Publication Year :
- 2018
-
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 (Δ<subscript>T2−T0</subscript> = + 10.0, p = 0.001) relative to the control group (Δ<subscript>T2−T0</subscript> = + 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV prevention
PREVENTIVE health services
ANTIRETROVIRAL agents
CLUSTER analysis (Statistics)
COMPARATIVE studies
DRUGS
ENDOWMENTS
PSYCHOLOGY of HIV-positive persons
LONGITUDINAL method
RESEARCH methodology
PATIENT compliance
STATISTICAL sampling
VIRAL load
SOCIOECONOMIC factors
RANDOMIZED controlled trials
AT-risk people
ODDS ratio
ADOLESCENCE
ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 10907165
- Volume :
- 22
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- AIDS & Behavior
- Publication Type :
- Academic Journal
- Accession number :
- 132698222
- Full Text :
- https://doi.org/10.1007/s10461-018-2173-7