Peer-reviewed article
Economic Empowerment, HIV Risk Behavior, and Mental Health Among School-Going Adolescent Girls in Uganda: Longitudinal Cluster-Randomized Controlled Trial, 2017‒2022
Fred M. Ssewamala, Rachel Brathwaite, Torsten B. Neilands ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether giving adolescent girls in Uganda savings accounts and family support programs would reduce HIV risk behaviors and improve mental health. Over 1,260 school girls aged 14-17 participated in a two-year randomized trial comparing three groups: standard health education, savings accounts alone, or savings accounts plus family counseling. Both savings-based interventions reduced depression and improved girls' sense of self-worth, but neither reduced sexual risk behaviors.
Key points
- Girls in both savings-based programs (YDA and YDA+MFG) showed significantly lower depressive symptoms at 24 months compared to controls
- Both interventions improved self-concept (how girls viewed themselves) at 24 months
- Only the combined intervention (savings plus family counseling) reduced hopelessness compared to controls
- Neither intervention significantly reduced sexual risk-taking behavior or changed attitudes about sex
- There was no meaningful difference between the savings-only and combined intervention groups on any outcome
Limitations
The study only measured school-going girls in Uganda, so results may not apply to out-of-school adolescents or other regions. The study did not find effects on sexual risk behavior, which was a primary outcome, limiting its ability to inform HIV prevention programs.
Abstract
Objectives. To investigate the long-term (12- and 24-month) impact of an economic empowerment intervention on HIV risk behaviors and mental health among school-going adolescent girls in Uganda. Methods. A total of 1260 girls aged 14 to 17 years were randomized at the school level to (1) standard health and sex education (controls; n = 408 students; n = 16 schools), (2) 1-to-1 matched savings youth development account (YDA; n = 471 students; n = 16 schools), or (3) combination intervention (YDA and multiple family group [YDA+MFG]; n = 15 schools; n = 381 students). Mixed-effects models were fitted. Results. YDA and YDA+MFG girls had significantly lower depressive symptoms and better self-concept than controls at 24 months. Only YDA+MFG girls had significantly lower hopelessness levels than controls. There were no significant study group differences at 12 and 24 months for sexual risk-taking behavior and attitudes. There was no significant difference between YDA and YDA+MFG groups for all outcomes. Conclusions. Providing YDA and MFG can positively improve adolescent girls’ mental health, but our analyses showed no significant differences across groups on sexual risk-taking behaviors. Future studies may consider replicating these interventions and analyses in older populations, including those transitioning into young adults. Trial Registration. ClinicalTrials.gov Identifier: NCT03307226. (Am J Public Health. 2023;113(3):306–315. https://doi.org/10.2105/10.2105/AJPH.2022.307169 )
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Youth development accounts (YDA) with matched savings, with or without multiple family group (MFG) counseling
- Population
- School-going adolescent girls aged 14-17 years in Uganda (n=1,260)
Key finding
YDA and YDA+MFG groups had significantly lower depressive symptoms than controls at 24 months
Ssewamala et al. · Prof. Fred M. Ssewamala (OpenAlex works) · 5 Jan 2023