Family Economic Empowerment, Family Social Support, and Sexual Risk-Taking Behaviors Among Adolescents Living With HIV in Uganda: The Suubi+Adherence Study

Thembekile Shato, Proscovia Nabunya, William Byansi, Ucheoma Nwaozuru, Moses Okumu, Massy Mutumba, Rachel Brathwaite, Christopher Damulira, Flavia Namuwonge, Ozge Sensoy Bahar, Torsten B. Neilands, Fred M. Ssewamala

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study examined the effect of a family economic empowerment (EE) intervention and family support on sexual risk-taking behaviors among adolescents living with HIV in rural Uganda. Methods: We used data from the Suubi + Adherence study, a longitudinal cluster randomized clinical trial of 702 adolescents living with HIV aged 10–16 years. Participants were randomly assigned to either the control arm (n = 358) receiving bolstered standard of care or a treatment arm (n = 344) receiving bolstered standard of care plus the family EE intervention. We used mixed-effects models to examine the effect of the EE intervention and family support on sexual risk-taking behaviors at the baseline, 12 months, and 24 months after intervention initiation. Results: Adolescents in both the intervention and control groups did not differ significantly in their sexual risk-taking attitudes at the baseline and over the 24-month follow-up period. Higher levels of caregiver social support were significantly associated with a decrease in attitudes toward sexual risk-taking (ß = −.40, 95%CI = −.51, −.29). More frequent parent-child communication was significantly associated with increased negative sexual risk-taking attitudes (ß = .21, 95%CI = .16, 26). Conclusions: Although we find no direct relationship between family EE and attitudes related to sexual risk-taking behaviors, we find that a supportive family environment can promote positive attitudes related to sexual risk-taking behaviors. The effectiveness of sexual risk reduction interventions would be enhanced by engaging families and strengthening supportive relationships between adolescents and their caregivers.

Original languageEnglish (US)
Pages (from-to)406-413
Number of pages8
JournalJournal of Adolescent Health
Volume69
Issue number3
DOIs
StatePublished - Sep 2021
Externally publishedYes

Keywords

  • Adolescents
  • Caregiver-child communication
  • Economic empowerment interventions
  • Family cohesion
  • Family support
  • HIV
  • Suubi
  • Uganda

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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