The Impact of an Economic Empowerment Intervention on Economic Security among AIDS-Orphaned Adolescents in Southern Uganda: the Moderating Role of Depression.

Abstract

Sub-Saharan Africa (SSA) bears a disproportionate HIV/AIDS burden, with adolescents heavily affected. Parental loss to AIDS has orphaned millions, exacerbating economic and psychosocial challenges. Economic empowerment interventions (EEIs) promote asset accumulation and financial stability, but the role of depression in moderating their effectiveness remains underexplored. This study examines the impact of an EEI on economic security among HIV/AIDS-orphaned adolescents in Southern Uganda, exploring depression as a moderator. Data from 1383 HIV-orphaned adolescents (10-16 years) were collected from 48 primary schools in Masaka, Uganda (2011-2016), under the Bridges to the Future study. Mixed-effects regression models assessed EEI impact on economic security, measured through physical assets (20-item index) and financial assets (savings yes/no). Depression (Child Depression Inventory) was included as a moderator. Participants' mean age was 12.68 years. The intervention significantly increased financial (χ²(8) = 32.79, p < 0.001) and physical assets (χ²(8) = 23.18, p = 0.003). Depression moderated both physical (χ²(12) = 52.89, p < 0.001) and financial asset accumulation (χ²(8) = 23.60, p = 0.023). Gender differences were also observed: the intervention positively impacted physical assets for females (χ²(8) = 38.41, p < 0.001) but not males (χ²(8) = 3.41, p = 0.906), while financial assets improved significantly for males (χ²(8) = 18.89, p = 0.015) but not females (χ²(8) = 13.33, p = 0.101). The EEI enhanced economic security among HIV/AIDS-orphaned adolescents, with gender-specific effects. Additionally, depression moderated asset accumulation, highlighting the need to integrate mental health support and adopt gender-sensitive approaches in EEIs to promote sustainable economic security. Trial Registration. ClinicalTrials.gov registration no. NCT01447615.