SUUBI+Adherence: Evaluating a Youth-Focused Economic Empowerment Approach to HIV Treatment Adherence

Principal Investigator: Fred Ssewamala, PhD

Project Team Members: Claude Mellins, PhD, Mary McKay, PhD, Irwin Garfinkel, PhD, Torsten Neilands, PhD, Godfrey Kigozi, PhD, Gertrude Nakigozi, PhD

Field Coordinators: Apollo Kivumbi, MPH(2012-2013), Miriam Mukasa (2013-Present)

Research Collaborators: Abel Mwebembezi (Reach the Youth-Uganda), Fr. Kato Bakulu (Masaka Diocese)

SUUBI+Adherence is a five-year longitudinal study (2012-2017) funded by the Eunice Kennedy Shriver National Institutes of Child Health & Human Development (NICHD). It examines the impact and cost associated with an economic empowerment intervention to increase adherence to HIV treatment for HIV positive adolescents in Uganda. The study is the first in Uganda to use a financial stability model to positively affect treatment adherence for youth. The study intervention, financial empowerment, combines a matched savings account, financial education, health education, and income-generating activities. This is meant to promote saving money for study participants and their families so there is sufficient income to meet the needs associated with managing HIV as a chronic illness, to provide support for adherence to antiretroviral therapy, to develop microenterprises to generate family income, and/or to further their studies in secondary education.

SUUBI+Adherence Publications

Nabunya, P., Sensoy Bahar, O., Chen, B., Dvalishvili, D., Damulira, C., & Ssewamala F. M., (2020) The role of family factors in antiretroviral therapy (ART) adherence self-efficacy among HIV-infected adolescents in southern Uganda. BMC Public Health 20, 340 PubMed

Damulira, C., Mukasa, M., Byansi, W., Nabunya, P., Kivumbi, A., Namatovu, P., Namuwonge, F., Dvalishvili, D., Sensoy Bahar, O., & Ssewamala, F. M. (2019). Examining the relationship of social support and family cohesion on ART adherence among HIV-positive adolescents in southern Uganda: Baseline findings. Vulnerable Child Youth Studies14(2), 181-190. PubMed

Gauer-Bermudez, L., Jennings, L., Ssewamala, F. M., Nabunya, P., Mellins, C. & McKay, M. (2016) Equity in adherence to antiretroviral therapy among economically-vulnerable adolescents living with HIV in Uganda. AIDS Care. NIHMS772360  PubMed

Gauer-Bermudez, L. G., Ssewamala, F. M., Neilands, T. B., Lu, L., Jennings, L., Nakigozi, G., Mellins, C., McKay, M., & Mukasa, M. (2018). Does economic strengthening improve viral suppression among adolescents living with HIV? Results from a cluster randomized trial in Uganda. AIDS and Behavior22(11), 3763-3772. doi:10.1007/s10461-018-2173-7 PubMed

Michalopoulos, L. M., Meinhart, M., Barton, S. M., Kuhn, J., Mukasa, M. N., Namuwonge, F., … Ssewamala, F. M. (2018). Adaptation and validation of the shame questionnaire among Ugandan youth living with HIV. Child Indicators ResearchSpringer

Ssewamala, F. M., Byansi, W., Sensoy Bahar, O., Nabunya, P., Neilands T.B., Mellins, Claude., McKay, M., Namuwonge, F., Mukasa, M., Makumbi, F.E., & Nakigozi, G. (2019). Suubi+Adherence Study Protocol: A family economic empowerment intervention addressing HIV treatment adherence for perinatally infected adolescents. Contemporary Clinical Trials Communications, 100459. PubMed

Ssewamala, F. M., Dvalishvili, D., Mellins, C., Geng, E., Makumbi, F., & Neilands, T. (in press). The long-term effects of a family based economic empowerment intervention (Suubi+Adherence) on suppression of HIV viral loads among adolescents living with HIV in southern Uganda: Findings from 5-year cluster randomized trial. PLoS One.

Tozan, Y., Sun, S., Capasso, A., Shu-Huah Wang, J., Neilands, T. B., Sensoy Bahar, O., S., Damulira, C., & Ssewamala, F. M. (2019). Evaluation of a savings-led family-based economic empowerment intervention for AIDS-affected adolescents in Uganda: A four-year follow-up on efficacy and cost-effectiveness. PloS one, 14(12), e0226809. PubMed