incidence of HIV or sexually transmitted

Effect of Economic Assets on Sexual Risk-Taking Intentions Among Orphaned Adolescents in Uganda.

The authors examined the effect of economic assets on sexual risk-taking intentions among school-going AIDS-orphaned adolescents in rural Uganda. AIDS-orphaned adolescents from 15 comparable schools were randomly assigned to control (n=133) or treatment (n=127) conditions. Treatment participants received child savings accounts, workshops, and mentorship. This economic intervention was in addition to the traditional care and support services for school-going orphaned adolescents (counselling and school supplies) provided to both treatment and control groups. Adolescents in the treatment condition were compared with adolescents in the control condition at baseline and at 10 months after the intervention. After control for sociodemographic factors, child caregiver/parental communication, and peer pressure, adolescents in the economic intervention group reported a significant reduction in sexual risk-taking intentions compared with adolescents in the control condition. The findings indicate that in Uganda, a country devastated by poverty and disease (including HIV), having access to economic assets plays an important role in influencing adolescents' sexual risk-taking intentions. These findings have implications for the care and support of orphaned adolescents, especially in poor African countries devastated by poverty and sexually transmitted diseases.

Editors’ note: Two conceptual frameworks underpinned this trial which tested a combined microfinance youth empowerment and health promotion programme for adolescents orphaned by AIDS against health promotion alone. The first was risk and resilience theory which suggests that family resources, including economic assets, can buffer the effects of factors that would otherwise push adolescents toward engaging in sexual risk behaviour. The second is asset theory, which posits that people with more present assets expect to have more in the future. By extension, adolescents who have an increased belief that their future holds the promise of success might reduce their risk of unsafe sex. This innovative trial found significantly lower intentions to engage in risky sex among the adolescents in the intervention arm which consisted of twelve 1 to 2 hour workshops on assets building and financial planning, a monthly mentorship programme with peer mentors on future planning, and a child savings account dedicated to paying for secondary schooling or a family small business, in addition to the health promotion received by the other group. The savings were matched 2 for 1 by the study and, in the end, all the subjects opted to use the funds for schooling rather than a small business. What may have happened is that participation in the programme instilled a sense of hope for the future that did encourage adolescents to be more careful in making decisions affecting their future. There is no doubt that further research addressing the multidimensional aspects of orphan hood, or for that matter of poverty among adolescents, is needed for a combination prevention approach that includes behavioural, biomedical, and structural components and that uses the incidence of HIV or sexually transmitted infections as endpoints.