Exploring pathways to adherence and retention for HIV-positive savings group members in Ethiopia

ABSTRACT

Savings groups are an economic strengthening intervention used to enhance the well-being of vulnerable groups. However, it is unclear how savings groups influence treatment outcomes for people living with HIV. This article reports on a study that conducted 48 in-depth interviews with HIV-positive savings group members in Ethiopia and used their narratives to qualitatively assess pathways linking savings group participation to adherence, retention, and general well-being. No single pathway was described, but almost the entire sample described improved adherence or retention through a combination of increased food security, economic and social well-being. The complexity of pathways supports the necessity for multisectoral approaches that address structural barriers to care.

KEYWORDS:

• Labour and livelihoods – Poverty reduction
• Social sector – HIV/AIDS and sexual health
• Sub-Saharan Africa

Acknowledgements

This study was undertaken under FHI 360’s Household Economic Strengthening Activity project with the generous financial support of the American people through the United States Agency for International Development (USAID) under Cooperative Agreement No. AID-066-LA-134-00002. The contents are the responsibility of FHI 360 and do not necessarily reflect the views of USAID or the United States Government. The authors are grateful to the Ethiopian data collection team, the Urban HIV/AIDS Nutrition and Food Security (UHANFS) project, and the participants for their efforts and contributions. The authors also extend their appreciation to several colleagues and peer reviewers, including Carina Omoeva, Kathleen MacQueen, and Emily Namey.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was undertaken under FHI 360’s Household Economic Strengthening Activity project with the generous financial support of the American people through the United States Agency for International Development (USAID) under Cooperative Agreement No. AID-066-LA-134-00002.

Notes on contributors

Lara Lorenzetti

Lara Lorenzetti is an Associate Scientist in the Behavioral, Epidemiological, and Clinical Sciences division at FHI 360. Her current research focuses on examining economic strengthening interventions and integrated approaches that improve the well-being of vulnerable populations. She also serves as an adjunct assistant professor in Health Policy and Management at the University of North Carolina at Chapel Hill.

Diana Rutherford

Diana Rutherford was a Senior Research and Evaluation Specialist in the Global Education, Employment, and Engagement division at FHI 360. She led the Youth Power Action Integrated Workforce Development and Sexual & Reproductive Health Assessments as well as studies examining the effect of savings group participation. She is currently an independent consultant leading studies with vulnerable youth in developing countries.

Befikadu Ejeta

Befikadu Ejeta is a Research Specialist working at FHI 360 in Addis Ababa, Ethiopia. He conducts monitoring and evaluation for several projects, including work examining how savings group participation influences outcomes for people living with HIV and vulnerable children.