Feasibility and acceptability of an integrated economic empowerment and substance use risk reduction intervention for youth living with HIV in Uganda

A pilot cluster randomized study

Datos Bibliográficos

ID19440693
AutoresMassy Mutumba (0000-0002-0636-891X, Washington University in St. Louis, autor de correspondencia), Rachel Brathwaite (0000-0002-9363-3581, Washington University in St. Louis), Sylvia Nannono (International Center for Child Health and Development, Masaka, Uganda), Anita Kabarambi (0000-0003-0551-1267, Washington University in St. Louis), Fred M Ssewamala (0000-0002-4849-5650, Innovations for Poverty Action)
Año2026
Páginas1-16
Fecha de publicación2026-04-08
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaAIDS Care (JOURNAL)
Identificadores de la revistaISSN: 0954-0121 • E-ISSN: 1360-0451
EditorialInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2026.2655052
PMID41952290
OpenAlexW7152700253
IdiomaEN
Referencias citadas45

Youth living with HIV (YLHIV) in sub-Saharan Africa experience high rates of alcohol and drug use (ADU), yet evidence-based interventions remain limited. We conducted a pilot cluster randomized trial to assess the feasibility, acceptability, and short-term outcomes of a life-skills-based Alcohol and Drug Use Risk Reduction intervention (ADURR), delivered alone or combined with economic empowerment (EE) through financial literacy training and matched savings accounts. Ninety-five YLHIV aged 18 to 24 years were enrolled from six clinics in southwestern Uganda and followed at baseline, 3 months, and 6 months using surveys and urine toxicology. Participants had a mean age of 21.9 years, and 65.3% were female. Retention at 6 months was 94.7%. Compared with ADURR-only, the ADURR+EE intervention was associated with larger declines in self-reported past-6-month drug use (-20.1 vs -5.8 percentage points), alcohol use (-17.9 vs -6.5 percentage points). Urine-confirmed drug use decreased in both arms (-30.4 vs -26.7 percentage points), while urine-confirmed alcohol use declined only in ADURR+EE (-33.1 percentage points). Psychosocial changes were modest; hopelessness decreased in ADURR+EE (-6.4%) but increased in ADURR-only (+13.0%). Qualitative findings indicated high acceptability, though savings uptake faced structural barriers. Findings support progression to a fully powered trial

Cluster (spacecraft) · Cluster randomised controlled trial · Empowerment · Intervention (counseling) · Psychological intervention · Psychosocial · Randomized controlled trial · Substance use · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Substance Abuse Treatment and Outcomes