Although individuals diagnosed with HIV are now living longer because of antiretroviral drugs, recent global reports have found that young people between the ages of 15 and 21 continue to be the exception.
For assistant professor Rainier Masa, the answer to why adolescents are dying more quickly than others may rest with his current work in Zambia. There, he and associate professor Gina Chowa are just beginning to examine how a young person’s social and emotional skill development and financial capability may impact the individual decision to remain in care and to take needed drugs to combat HIV.
“The drugs that these young people have to take are provided free of charge by local clinics, but they are disproportionately not adhering to their medications – they’re not taking their pills or they’re stopping their treatment for various reasons,” said Masa, who conducts research on the intersection of economic security and health, including HIV prevention and treatment behaviors. “I think it’s because they are at that stage developmentally when they’re trying to be independent and trying to build their own relationships, while at the same time they’re trying to figure out how to deal with the stigma of HIV and whether to disclose their status. So, their brain functioning is developing, and it’s not only affecting their cognition but their interpersonal relationships.”
A feasibility study in Eastern Province, Zambia, may be a first step in providing these young people with the support they need to live healthier lives, Masa said. He is leading the study with support from the UNC Center for AIDS Research and in partnership with Rising Fountains Development Program, Lundazi District Medical Office, and Chipata General Hospital, all of Zambia. The immediate goal: to evaluate viability and acceptability of an intervention and its research procedures. The project will collect data from 120 adolescents, their caregivers and health workers to determine if the researchers can get enough community buy in and participation to conduct a longer-term research project.
The feasibility study largely involves a population that was infected perinatally and focuses on an intervention program designed to strengthen participants’ skills in critical thinking, problem solving, decision-making, and interpersonal relationship building, Masa said. The program also incorporates a savings and financial literacy component to improve participants’ financial means.
“The goal is not just to provide the adolescents with intangible assets such as the social and emotional skills but provide them with tangible assets in the form of savings,” Masa explained. “And then we want to know if having both of these assets will really help them adhere to their treatment.”
The feasibility study builds on Global Social Development Innovations’ (GSDI) earlier work in Zambia, which focused on improving economic opportunities, food security and overall well-being of people living with HIV. Masa is GSDI’s lead researcher for health and social protection.
Long-term, Masa hopes to use his findings to expand the study and examine its impact.
“Given all the work we’ve been doing to improve youth outcomes, I think this is a sub-population that has a lot of unmet needs,” Masa said. “Ultimately, the goal is to ensure that these young people are healthy as long as possible.”