Thembekile Shato1, Proscovia Nabunya1, William Byansi1, Ucheoma Nwaozuru1, Moses Okumu2, Massy Mutumba3, Rachel Brathwaite1, Christopher Damulira4, Flavia Namuwonge4, Ozge Sensoy Bahar1, Torsten B Neilands5, Fred M Ssewamala6. 1. International Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, St. Louis, Missouri. 2. School of Social Work, University of North Carolina-Chapel, Chapel Hill, North Carolina. 3. Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan. 4. International Center for Child Health and Development (ICHAD), Masaka, Uganda. 5. Division of Prevention Science, Center for AIDS Prevention Studies (CAPS), Department of Medicine, University of California San Francisco, San Francisco, California. 6. International Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, St. Louis, Missouri. Electronic address: fms1@wustl.edu.
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.
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.
Authors: Fred M Ssewamala; Leyla Ismayilova; Mary McKay; Elizabeth Sperber; William Bannon; Stacey Alicea Journal: J Adolesc Health Date: 2010-04 Impact factor: 5.012
Authors: Sabrina Bakeera-Kitaka; Nicolette Nabukeera-Barungi; Christiana Nöstlinger; Kekitiinwa Addy; Robert Colebunders Journal: AIDS Care Date: 2008-04
Authors: Fred M Ssewamala; William Byansi; Ozge Sensoy Bahar; Proscovia Nabunya; Torsten B Neilands; Claude Mellins; Mary McKay; Flavia Namuwonge; Miriam Mukasa; Fredrick Edward Makumbi; Gertrude Nakigozi Journal: Contemp Clin Trials Commun Date: 2019-10-20