Evidence map›Paper›PMID 40500555›Full record

Trial reportPrevention science : the official journal of the Society for Prevention Research2025

The Effect of Depression on the Pathways Between an Economic Strengthening Intervention and ART Adherence in Youths with HIV: Findings from a Moderated Mediation Model of the Suubi + Adherence Cluster-Randomized Study.

Samuel Kizito, Fred M Ssewamala, Josephine Nabayinda, Proscovia Nabunya, Ozge Sensoy Bahar, Torsten B Neilands, Mary M McKay

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Prevention science : the official journal of the Society for Prevention Research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Samuel KizitoInternational Center for Child Health and Development, Brown School, Washington University, St. Louis, MO, 63130, USA. kizito.s@wustl.edu.ORCID 0000-0003-2413-0398
Fred M SsewamalaInternational Center for Child Health and Development, Brown School, Washington University, St. Louis, MO, 63130, USA.
Josephine NabayindaInternational Center for Child Health and Development, Brown School, Washington University, St. Louis, MO, 63130, USA.
Proscovia NabunyaInternational Center for Child Health and Development, Brown School, Washington University, St. Louis, MO, 63130, USA.
Ozge Sensoy BaharInternational Center for Child Health and Development, Brown School, Washington University, St. Louis, MO, 63130, USA.
Torsten B NeilandsDivision of Prevention Science, University of California, San Francisco, CA, 94143, USA.
Mary M McKayInternational Center for Child Health and Development, Brown School, Washington University, St. Louis, MO, 63130, USA.

Funding

Suubi+Adherence-R2: Examining the longitudinal HIV treatment adherence among youth living with HIV (YLHIV) transitioning into young adulthoodR01HD074949 · NICHD · WASHINGTON UNIVERSITY · PI NABUNYA, PROSCOVIA, SENSOY BAHAR, OZGE · 2012 to 2024
$7.7M
Eunice Kennedy Shriver National Institute of Child Health and Human Development 1R01HD074949NICHD NIH HHS R01 HD074949
6 · The paper itself

Abstract

Adolescents living with HIV (ALHIV) have low adherence to antiretroviral therapy (ART). Poverty and mental health challenges remain major drivers of this poor ART adherence. We explored the mediators of the impact of an economic empowerment intervention on ART adherence among ALHIV and assessed the moderating effects of depression. We randomized 39 clinics (702 participants) into the control or intervention groups. Participants were aged 10-16, living with HIV and taking ART. The intervention comprising matched savings account, financial literacy training, and microenterprise workshops. We fitted a sequential structural equation model to examine how the three mediators-HIV stigma, barriers to medical care, and healthcare transition readiness-influenced ART adherence at year seven. Depression was included as a moderator. At baseline, the mean age was 12 years, and only 73.0% achieved good adherence (≥ 90%). The intervention directly improved ART adherence, β = 0.060 (95% CI: 0.038, 0.081), p < 0.001. Also, there was a significant indirect effect of the intervention on ART adherence, mediated through barriers to medical care, β =  - 0.036 (95% CI: - 0.041, - 0.032), p < 0.001, and HIV stigma, β =  - 0.011 (- 0.016, - 0.007), p < 0.001. Depression reduced the effect of the intervention on ART adherence β =  - 0.114 (- 0.123, - 0.104), p < 0.001. Our results showed that providing ALHIV with financial resources improved their ART adherence; however, this was affected by depression. Therefore, programs aimed at improving outcomes in ALHIV should consider incorporating interventions that address mental health challenges in addition to poverty.

Indexed as

Anti-HIV AgentsDepressionHIV InfectionsMedication AdherenceAdolescentChildFemaleHumansMaleSocial StigmaAnti-HIV AgentsAdolescentsAntiretroviral therapy adherenceDepressionEconomic empowermentHIV/AIDSSub-Saharan Africa

Identifiers

PMID40500555
PMCPMC13003161

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.