TY - JOUR
T1 - Family Economic Empowerment, Family Social Support, and Sexual Risk-Taking Behaviors Among Adolescents Living With HIV in Uganda
T2 - The Suubi+Adherence Study
AU - Shato, Thembekile
AU - Nabunya, Proscovia
AU - Byansi, William
AU - Nwaozuru, Ucheoma
AU - Okumu, Moses
AU - Mutumba, Massy
AU - Brathwaite, Rachel
AU - Damulira, Christopher
AU - Namuwonge, Flavia
AU - Bahar, Ozge Sensoy
AU - Neilands, Torsten B.
AU - Ssewamala, Fred M.
N1 - Funding Information:
Financial support for the Suubi + Adherence study came from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), (Grant #R01HD074949, PI: Fred M. Ssewamala, PhD). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or the National Institutes of Health (NIH). The authors are grateful to the staff and the volunteer team at the International Center for Child Health and Development in Uganda for monitoring the study implementation process. Our special thanks go to all the children and their caregiving families who agreed to participate in the study.
Funding Information:
Financial support for the Suubi + Adherence study came from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), (Grant # R01HD074949 , PI: Fred M. Ssewamala, PhD). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or the National Institutes of Health (NIH). The authors are grateful to the staff and the volunteer team at the International Center for Child Health and Development in Uganda for monitoring the study implementation process. Our special thanks go to all the children and their caregiving families who agreed to participate in the study.
Publisher Copyright:
© 2021 Society for Adolescent Health and Medicine
PY - 2021/9
Y1 - 2021/9
N2 - 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.
AB - 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.
KW - Adolescents
KW - Caregiver-child communication
KW - Economic empowerment interventions
KW - Family cohesion
KW - Family support
KW - HIV
KW - Suubi
KW - Uganda
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U2 - 10.1016/j.jadohealth.2021.02.005
DO - 10.1016/j.jadohealth.2021.02.005
M3 - Article
C2 - 33812750
AN - SCOPUS:85103565585
VL - 69
SP - 406
EP - 413
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
SN - 1054-139X
IS - 3
ER -