International Center for Child Health and Development (ICHAD), Brown School, Washington University in St. Louis, St. Louis, MO, United States of America.
International Center for Child Health and Development (ICHAD), Uganda Field Office, Masaka, Uganda.
PLoS One. 2023 May 10;18(5):e0284572. doi: 10.1371/journal.pone.0284572. eCollection 2023.
Youth orphaned by HIV in sub-Saharan Africa experience immense hardships including social disadvantage, adverse childhood events and limited economic prospects. These adversities disrupt the normative developmental milestones and can gravely compromise their health and emotional wellbeing. The Bridges to the Future study (2012-2018) prospectively followed 1,383 adolescents, between 10-16 years, to evaluate the efficacy and cost-effectiveness of a family-based economic empowerment intervention comprising of child development accounts, financial literacy training, family income generating activities and peer mentorship. Study findings show efficacy of this contextually-driven intervention significantly improving mental health, school retention and performance and sexual health. However, critical questions, such as those related to the longitudinal impact of economic empowerment on HIV prevention and engagement in care remain. This paper presents a protocol for the follow-up phase titled, Bridges Round 2.
The Original Bridges study participants will be tracked for an additional four years (2022-2026) to examine the longitudinal developmental and behavioral health outcomes and potential mechanisms of the effect of protective health behaviors of the Bridges cohort. The study will include a new qualitative component to examine participants' experiences with the intervention, the use of biomedical data to provide the most precise results of the highly relevant, but currently unknown sexual health outcomes among study participants, as well as a cost-benefit analysis to inform policy and scale-up.
Study findings may contribute to the scientific knowledge for low-resource communities on the potential value of providing modest economic resources to vulnerable boys and girls during childhood and early adolescence and how these resources may offer long-term protection against known HIV risks, poor mental health functioning and improve treatment among the HIV treatment care continuum.
撒哈拉以南非洲地区因艾滋病而成为孤儿的青年经历了巨大的困难，包括社会劣势、童年逆境和有限的经济前景。这些逆境打乱了正常的发展里程碑，严重损害了他们的健康和情绪健康。未来之桥研究（2012-2018 年）前瞻性地跟踪了 1383 名 10-16 岁的青少年，以评估包括儿童发展账户、金融扫盲培训、家庭收入产生活动和同伴指导在内的基于家庭的经济赋权干预的疗效和成本效益。研究结果表明，这种背景驱动的干预措施具有疗效，可显著改善心理健康、学校保留率和成绩以及性健康。然而，仍存在一些关键问题，例如与经济赋权对艾滋病毒预防和护理参与的长期影响相关的问题。本文介绍了一个名为“桥梁第二轮”的后续阶段的方案。
原始桥梁研究的参与者将再跟踪四年（2022-2026 年），以研究桥梁队列的保护健康行为的长期发展和行为健康结果和潜在机制。该研究将包括一个新的定性部分，以研究参与者对干预的体验，使用生物医学数据提供最精确的研究参与者的高度相关但目前未知的性健康结果，以及成本效益分析，以告知政策和扩大规模。
研究结果可能为资源匮乏社区的科学知识做出贡献，了解在儿童和青春期早期向弱势男孩和女孩提供适度经济资源的潜在价值，以及这些资源如何为已知的艾滋病毒风险、心理健康功能不良和改善艾滋病毒治疗护理连续体中的治疗提供长期保护。
