Peer-reviewed article
Suubi + Adherence4Youth: a study protocol to optimize the Suubi Intervention for Adherence to HIV treatment for youth living with HIV in Uganda
Fred M. Ssewamala, John A. Sauceda, Rachel Brathwaite, Torsten B. Neilands, Proscovia Nabunya et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study protocol describes a trial to test which components of the Suubi intervention work best for improving HIV treatment adherence in adolescents aged 11-17 in Uganda. Suubi combines financial literacy training, youth savings accounts, adherence counselling, and peer mentoring. The study will randomize 576 adolescents living with HIV across 48 clinics to different combinations of these four components to identify the most effective and affordable approach. The research will track outcomes over four years to understand which components matter most for viral suppression and mental health.
Key points
- Suubi is a multi-component intervention addressing psychosocial and economic factors affecting HIV treatment adherence in adolescents
- The study uses a factorial design testing all 16 possible combinations of 4 intervention components across 48 clinics
- 576 adolescents living with HIV aged 11-17 will be enrolled and assessed at baseline and 12, 24, 36, and 48 months
- Primary outcome is viral suppression; secondary outcomes include mental health, family financial stability, and family cohesion
- The study aims to identify the minimal effective package that is sustainable, affordable, and scalable
Limitations
This is a study protocol, not results. The document describes planned methods and does not yet provide evidence of what works. Actual implementation challenges, participant retention rates, and outcome findings are not yet available.
Abstract
BACKGROUND: Suubi is an evidenced based multi-component intervention that targets psychosocial and economic hardships to improve ART adherence, viral suppression, mental health, family financial stability, and family cohesion for adolescents living with HIV (ALHIV) in Uganda. Suubi was originally tested as a combined package of four components: 1) Financial Literacy Training; 2) incentivized matched Youth Savings Accounts with income-generating activities; 3) a manualized and visual-based intervention for ART adherence and stigma reduction; and 4) engagement with HIV treatment-experienced role models. However, it is unknown if each component in Suubi had a positive effect, how the components interacted, or if fewer components could have produced equivalent effects. Hence, the overall goal of this new study is to identify the most impactful and sustainable economic and psychosocial components across 48 health clinics in Uganda. METHODS: A total of 576 ALHIV (aged 11-17 years at enrollment) will be recruited from 48 clinics and each clinic will be randomized to one of 16 study conditions. Each condition represents every possible combination of the 4 components noted above. Assessments will be conducted at baseline, 12, 24, 36 and 48- months post-intervention initiation. Using the multi-phase optimization strategy (MOST), we will identify the optimal combination of components and associated costs for viral suppression, as well as test key mediators and moderators of the component-viral suppression relationship. DISCUSSION: The study is a shift in the paradigm of research to use new thinking to build/un-pack highly efficacious interventions that lead to new scientific knowledge in terms of understanding what drives an intervention's success and how to iterate on them in ways that are more efficient, affordable and scalable. The study advances intervention science for HIV care outcomes globally. TRIAL REGISTRATION: This project was registered at clinicaltrials.gov (NCT05600621) on October, 31, 2022. https://clinicaltrials.gov/ct2/show/NCT05600621.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Suubi + Adherence4Youth: a multi-component intervention combining financial literacy training, incentivized matched youth savings accounts with income-generating activities, a manualized visual-based ART adherence and stigma reduction intervention, and engagement with HIV treatment-experienced role
- Population
- 576 adolescents living with HIV aged 11-17 years enrolled from 48 health clinics in Uganda
Key finding
Study protocol describes plans to test component combinations but does not yet report results
Ssewamala et al. · Prof. Fred M. Ssewamala (OpenAlex works) · 20 Apr 2023