This study examines an economic empowerment model of care and support for orphaned adolescents in rural Uganda. Under this model, 277 AIDS-orphaned youths (ages 11-17) from 15 comparable schools were randomly assigned to either the usual care, which involves provision of counseling and education-related supplies, or the experimental condition, in which participants also received matched-savings accounts. The analyses indicate that poor families in rural Uganda can and do save for their youths if provided with support and incentives. Analyses also locate statistically significant differences between youths in the experimental and control groups on attitudes toward saving, academic performance, educational aspirations, and health-related behaviors. The results suggest that savings-related interventions have a place in the care and support of orphaned youths in poor sub-Saharan Africa, where the number of such youths is steadily increasing.In most parts of sub-Saharan Africa, the burden of raising youths who have lost one or both parents (hereafter, "orphaned youths" or "orphans") falls primarily on extended family members, including grandparents, uncles, and aunts. However, the steady increase in the number of orphans, coupled with the increase in poverty that comes from the loss of wageearning parents, is contributing to a breakdown in the African extended family system. Because there are few public welfare programs to serve them, many orphans are left to fend for themselves. In Uganda, a poor sub-Saharan African country heavily affected by wars and disease, over 2.3 million youths have lost one or both parents (UNICEF 2007). This represents approximately 8 percent of the country's population (World Bank 2008).For these reasons, UNICEF recently called on organizations to move away from institutional care and to develop efficient and sustainable family-centered programs (UNICEF 2008). Because of the number of orphaned youths, extended families often are not willing or able to take in additional orphans, even if the youths are their kin. This phenomenon pushes most of the youths into one of three options. One is institutional care, an approach that is heavily criticized. Institutional care allegedly costs more than family-based care, isolates youths from socializing experiences in the community, and separates them from family-level protective factors crucial to emotional, cognitive, and overall psychosocial development (Johnson, Browne, and Hamilton-Giachritsis 2006;Mulheir and Browne 2007). Institutional care also is found to negatively affect youths' normal psychosocial functioning and mental well-being (Vorria et al. 1998a(Vorria et al. , 1998b(Vorria et al. , 2006Maclean 2003;Nelson et al. 2007).The second option commonly available to orphans involves settings in which they depend on reactive strategies that take the form of aid in food, clothing, and other materials from Notes: Excerpts of this article were presented at the Faith-Based and Community Initiatives Conference on Research, Outcomes, and Eva...

Purpose This paper examines gender differences in attitudes towards sexual risk-taking behaviors of AIDS-orphaned youth participating in a randomized control trial testing an economic empowerment intervention in rural Uganda. Methods Adolescents (average age 13.7 years) who had lost one or both parents to AIDS from fifteen comparable schools were randomly assigned to either an experimental (n=135) or control condition (n=142). Adolescents in the experimental condition, in addition to usual care, also received support and incentives to save money toward secondary education. Results Findings indicate that although adolescent boys and girls within the experimental condition saved comparable amounts, the intervention appears to have benefited girls, in regards to the attitudes towards sexual risk-taking behavior, in a different way and to a lesser extent than boys. Conclusions Future research should investigate the possibility that adolescent girls might be able to develop equally large improvements in protective attitudes towards sexual risk-taking through additional components that address gendered social norms.

Objectives-To examine the effect of economic assets on sexual risk taking intentions among school-going AIDS-orphaned adolescents in rural Uganda.Methods-AIDS-Orphaned adolescents from fifteen 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 (counseling and school supplies) provided to both treatment and control groups. Adolescents in the treatment condition were compared to adolescents in the control condition at baseline and at 10-month post-intervention.Results-Controlling for socio-demographic factors, child-caregiver/parental communication and peer pressure, adolescents in the economic intervention group reported a significant reduction in sexual risk taking intentions compared to adolescents in the control condition.Conclusions-The findings indicate that in Uganda, a country devastated by poverty and disease (including HIV/AIDS), having access to economic assets plays an important role in influencing adolescents' sexual risk taking intentions. These findings have implications for care and support of orphaned adolescents, especially in poor African countries devastated by poverty and sexually transmitted diseases.

Purpose By adversely affecting family functioning and stability, poverty constitutes an important risk factor for children’s poor mental health functioning. This study examines the impact of a comprehensive microfinance intervention, designed to reduce the risk of poverty, on depression among AIDS-orphaned youth. Methods Children from 15 comparable primary schools in Rakai District of Uganda, one of those hardest hit by HIVAIDS in the country, were randomly assigned to control (n=148) or treatment (n=138) conditions. Children in the treatment condition received a comprehensive microfinance intervention comprising of matched savings accounts, financial management workshops, and mentorship. This was in addition to traditional services provided for all school-going orphaned adolescents (counseling and school supplies). Data were collected at wave 1 (baseline), wave 2 (10-months postintervention), and wave 3 (20-months post-intervention). We used multilevel growth models to examine the trajectory of depression in treatment and control conditions, measured using Children’s Depression Inventory (Kovacs). Results Children in the treatment group exhibited a significant decrease in depression whereas their control group counterparts showed no change in depression. Conclusion The findings indicate that over and above traditional psychosocial approaches used to address mental health functioning among orphaned children in sub-Saharan Africa, incorporating poverty alleviation-focused approaches, such as this comprehensive microfinance intervention, has the potential to improve psychosocial functioning of these children.

This study tested an economic intervention to reduce HIV risks among AIDS-orphaned adolescents. Adolescents (n = 96) were randomly assigned to receive the intervention or usual care for orphans in Uganda. Data obtained at baseline and 12-month follow-up revealed significant differences between the treatment and control groups in HIV prevention attitudes and educational planning. KeywordsInternational; AIDS orphaned adolescents; AIDS orphan care and support; Economic intervention; Africa; Poverty AIDS is a global public health and medical crisis, particularly for the people of sub-Saharan Africa. In Uganda-a country especially threatened by AIDS-over 1 million children have lost one or both parents due to the disease [1]. The number of these AIDS orphans are expected to increase by 50,000 annually [2]. Facing multiple problems, AIDS orphans in Uganda sorely need responsive interventions to help them prevent their own HIV infection and advance their educational and economic futures, despite their disadvantaged status. Poverty is a risk factor for many health and medical problems, yet the majority of intervention studies do not target economic well-being as a primary outcome. This study tests an economic intervention for AIDS-orphaned adolescents in Uganda. Based on asset theory [3], the intervention employs such assets as children savings accounts, family microenterprises, and scholarships to fight poverty and promote health and social functioning. Asset theory predicts that an orphaned adolescent with no belief that he/she has the economic means to afford postprimary education is more likely to have high levels of depression, academic difficulties, and consequently drop out of school, and is less likely to be able or have the desire to avoid negative health consequences. However, provided with the economic means, this adolescent may think and behave differently, staying in school, and avoiding health-risk behaviors. Asset theory is consistent with other behavioral and psychosocial theories (e.g., theory of reasoned action [4] and social learning theory [5] None of these studies, however, focused on care and support for adolescents through microfinance.Based on asset-theory, the pathway we are proposing as a result of an adolescent participating in the microfinance/economic intervention would be that intervention creates and/or increases adolescents' savings, which in turn, increases their overall resources. Greater resources improve adolescents' expectations for the future and their well-being, leading to continued schooling (future educational planning) and positive health behaviors (including attitudes toward engaging in HIV risk behaviors). Methods Study designIn an experimental design (protocol approved by Columbia University IRB), 96 AIDSorphaned adolescents from seven comparable primary schools in Rakai district of southern Uganda were randomly assigned to experimental (n = 50) and comparison conditions (n = 46). Randomization was carried out at the level of the school. Each adolescent assented to s...