Bridges Round 2: Examining the longitudinal impacts of an economic empowerment intervention on HIV risk prevention and care continuum outcomes among orphaned youth transitioning to young adulthood.
Principal Investigators: Fred M. Ssewamala, PhD, Ozge Sensoy Bahar, PhD, Proscovia Nabunya, PhD
Project Team Members: Patricia Cavazos-Rehg, PhD, Noeline Nakasujja, PhD (Makerere University), Torsten Neilands, PhD (University of California San Francisco)
Implementing Partners: Barbara Mukasa, MBChB (Mildmay Uganda), Abel Mwebembezi, PhD (Youth the Reach Uganda)
Study Coordinators: Phionah Namatovu, MPH; Winnie Kirabo; Josephine Nabayinda, MSc.
Funded by the National Institute of Mental Health (NIMH), Bridges Round 2 study (hereafter, Bridges-R2), builds on the original Bridges to the Future Study (2011-2018), to examine the longitudinal impacts of an economic empowerment intervention on HIV risk prevention and care continuum outcomes among orphaned youth transitioning to young adulthood. Findings from the first round of the study filled important gaps on the effects of an economic empowerment intervention on short term stability. However, the extent to which these observed short-term behaviors are sustained over time is unknown. Yet, given the unique vulnerabilities during the transition into young adulthood, it is critical to examine the long-term effectiveness of economic empowerment across the life course of youth orphaned by HIV. The study will follow the Bridges cohort (N=1383 orphaned youth) for an additional 4-year period, with three data points, to address the following specific aims:
Aim 1. Examine the long-term impact of Bridges on: HIV prevalence (measured via participant’s HIV status); and explore in secondary analyses the long-term impact of Bridges on key developmental and behavioral outcomes (e.g., mental health, alcohol, and drug misuse);
Aim 2. Elucidate the long-term effects of Bridges on potential mechanisms of change, including: a) economic stability, viral suppression (for ALHIV); PrEP use (for HIV negative adolescents), medical male circumcision (for boys); and b) young adult transitions;
Aim 3: Qualitatively investigate participants’ experiences with Bridges that may have influenced engagement with the program, sexual risk-taking decisions, financial behaviors; experiences with developmental transitions; and perceptions on program sustainability;
Aim 4: To assess the long-term costs and benefits of Bridges using formal economic evaluation.
Findings from this study may enable us to contribute to the scientific knowledge for low-resource communities on the potential value of providing modest economic resources to vulnerable boys and girls during childhood and early adolescence and how these resources may offer long-term protection against known HIV risks, health and treatment outcomes.
Principal Investigator: Fred Ssewamala, PhD
Project Team Members: Irwin Garfinkel, PhD, Jane Waldfogel, PhD, Jeanne Brooks-Gunn, PhD, Torsten Neilands, PhD
Field Coordinators: Miriam Mukasa, Christopher Damulira
Research Collaborators: Abel Mwebembezi (Reach the Youth-Uganda), Fr. Kato Bakulu (Masaka Diocese)
Bridges to the Future: A Family-Based Economic Empowerment Intervention for Children Orphaned by AIDS in Uganda, is a five-year longitudinal study (2011-2016) funded by the Eunice Kennedy Shriver National Institutes of Child Health & Human Development (NICHD). It evaluates the impact and cost-effectiveness of an innovative family-based economic empowerment intervention for orphans made vulnerable by AIDS. The study intervention includes a matched savings account registered in the child’s name, income-generating activity training, and mentorship. The intervention aims to encourage saving money for secondary education, promote microenterprise development to generate family income and provide support programs to protect children from future risks. Currently the study is in a no-cost extension.
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