Abstract: Effects of a Savings-Led Economic Empowerment Intervention on HIV Preventive Practices Among AIDS-Orphaned Adolescents in Rural Uganda: Results from the Suubi-Maka Project (Society for Social Work and Research 20th Annual Conference - Grand Challenges for Social Work: Setting a Research Agenda for the Future)

Effects of a Savings-Led Economic Empowerment Intervention on HIV Preventive Practices Among AIDS-Orphaned Adolescents in Rural Uganda: Results from the Suubi-Maka Project

Sunday, January 17, 2016: 1:00 PM
Meeting Room Level-Meeting Room 8 (Renaissance Washington, DC Downtown Hotel)
* noted as presenting author
Larissa Jennings, PhD, Assistant Professor, John Hopkins Bloomberg School of Public Health, Baltimore, MD
Fred M. Ssewamala, PhD, Associate Professor, Columbia University, New York, NY
Proscovia Nabunya, MSW, Doctoral Candidate, University of Chicago, Chicago, IL
Significance and Purpose: Improving economic resources of impoverished youth may alter intentions to engage in sexual risk-taking behaviors by motivating more positive future planning to avoid negative consequences, including HIV infection. Yet, few studies have examined the impact of economic strengthening on sexual risk-taking intentions and HIV preventive practices of AIDS-orphaned youth, despite high poverty and high HIV infection in this population. This study assessed the effects of a savings-led economic empowerment intervention, on asset savings and HIV preventive practices among adolescents in rural Uganda.

Methods: This study utilized data from the NIMH funded study, called Suubi-Maka (Hope for Families). Data was collected from a sample of 346 AIDS-orphaned youth, aged 12-16, living in rural Uganda. Participants were randomly assigned to either the control condition (n=167) receiving usual care of services for school-going orphaned youth (scholastic materials and food aid) or the treatment condition (n=179) receiving a savings-led economic empowerment intervention comprising of a youth matched savings account, financial planning and management workshops, and a mentorship program. Interviews were conducted at baseline, 10-month, and 20-month post intervention initiation. Hierarchical longitudinal regressions were conducted to assess the effect of the intervention, on changes over time in asset savings and HIV preventive practices among adolescents.

Findings: Results showed that compared to adolescents in the control condition, intervention adolescents significantly increased their cash savings over time (b=$US12.317, +1.122, p=0.000). At 24-months post-baseline, 92% of intervention adolescents had accumulated savings compared to 43% in the control (p<0.05). Intervention youth also placed increasing value on savings for the future with a significant relative increase in mean savings scores (b=0.252 +0.107 p=0.019) from baseline to 24 months post-baseline. The highest proportions of intervention adolescents valued saving money for animal husbandry (100%, n=166), one’s education (99.4%, n=165), and family assistance (97.0%, n=161). As compared to the control group, intervention youth also had an average relative increase over time in scores relating to HIV prevention attitudes (b=+0.189, +0.089, p=0.034), most commonly in regards to perceived risk of HIV (95.8%, n=159), postponement or abstinence from sex (91.6%, n=152), and consistent condom use (93.4%, n=144).

Implications: To minimize HIV risk throughout the adolescent and young adult periods, more effort is needed to develop long-term strategies that link youth-led savings, housing, and business development opportunities with combination prevention programs for high-risk youth, such as those orphaned due to HIV/AIDS.