Addressing depression, stress, and hopelessness through an economic and relationship-strengthening intervention: Findings from a pilot randomized controlled trial among people with HIV in Malawi.

Background: Depression disproportionately affects individuals in low- and middle-income countries (LMICs). Economic hardship and family strain exacerbate challenges, particularly for women. This study evaluated effects of Mlambe, an intervention targeting economic empowerment and relationship strengthening, on mental health in couples with HIV and unhealthy alcohol use in Malawi.

"After reducing alcohol, things now work well at home": Perceived impacts of the Mlambe intervention on alcohol use, relationship dynamics, household economics, and HIV treatment adherence in Malawian couples.

Unhealthy alcohol use is prevalent in sub-Saharan Africa and can worsen poverty, couple relationships, and HIV treatment outcomes. In response, we assessed participant experiences with Mlambe, a pilot study of an economic and relationship-strengthening intervention for couples living with unhealthy alcohol use and HIV. Exit interviews were conducted with a subset of 20 couples who participated in a pilot trial of Mlambe in Zomba, Malawi.

The effect of an economic empowerment and relationship strengthening intervention on food insecurity among couples living with HIV in Malawi.

Background: People living with HIV (PLHIV) are highly impacted by food insecurity through pathways including poor adherence to antiretroviral therapy and inadequate nutrition. Limited evidence exists on whether economic empowerment interventions can improve food insecurity among PLHIV in sub-Saharan Africa. We evaluated the effectiveness of Mlambe, an economic empowerment and relationship-strengthening intervention, on food insecurity among couples living with HIV who drink alcohol in Malawi.

Effects of economic empowerment and relationship strengthening intervention on financial behaviors among couples living with HIV: The pilot trial in Malawi.

Introduction: Economic insecurity, relationship issues, and gender-based financial disparities pose significant challenges for couples living with HIV in sub-Saharan Africa, potentially undermining treatment adherence and health outcomes. We evaluated , an integrated economic empowerment with relationship strengthening intervention for couples living with HIV.

Methods: We conducted a pilot randomized controlled trial in Zomba, Malawi with 78 married couples (156 individuals) living with HIV and reporting unhealthy alcohol use based on the AUDIT-C.

Economic and relationship-strengthening intervention to reduce alcohol use in couples living with HIV in Malawi: a study protocol for a randomised controlled trial of Mlambe.

Introduction: Heavy alcohol use has the potential to derail progress towards UNAIDS 95-95-95 targets for countries in sub-Saharan Africa (SSA). Within couples, alcohol use is closely linked with factors such as intimate partner violence and economic insecurity and can result in poor adherence to antiretroviral therapy (ART) and HIV clinical outcomes. We hypothesise that a combined economic and relationship intervention for couples that builds on the prior success of standalone economic and relationship-strengthening interventions will be efficacious for improving HIV clinical outcomes and reducing alcohol use.

Mlambe economic and relationship-strengthening intervention for alcohol use decreases violence and improves relationship quality in couples living with HIV in Malawi.

Introduction: A syndemic of unhealthy alcohol use, intimate partner violence (IPV), and economic insecurity threatens to derail progress towards UNAIDS 95-95-95 targets in sub-Saharan Africa. We developed a combined economic and relationship-strengthening intervention called Mlambe to reduce unhealthy alcohol use and increase adherence to antiretroviral therapy for couples in Malawi. This study evaluates the additional impact of Mlambe on IPV and relationship dynamics.

Pilot Trial Results of Mlambe: An Economic and Relationship-Strengthening Intervention to Address Heavy Drinking and Adherence to Antiretroviral Therapy in Malawi.

We evaluated the feasibility, acceptability, and preliminary efficacy of an economic and relationship-strengthening intervention to reduce heavy alcohol use among couples living with HIV in Malawi (Mlambe). Mlambe consisted of training on financial literacy and relationship skills, combined with 1:1 matched savings accounts to invest in an income-generating activity. In a randomized controlled trial, we compared Mlambe to enhanced usual care (EUC).

Structural Inequities, Syndemics, and Resilience: The Critical Role of Social Support in Overcoming Barriers and Empowering Engagement in HIV Care for Young Black Sexual-Minority Men in the US South.

Young Black sexual minority men (YBSMM) living in the US South are among those most disproportionately impacted by HIV in the USA. This health inequity is, in part, due to lower rates of sustained engagement in the HIV care continuum, resulting in a lower prevalence of viral suppression and higher overall community-level viral load. Social, structural, and economic inequities have previously been linked with poorer HIV care engagement among YBSMM.

Differential Associations of Depressive Symptomology to HIV Care Engagement Among Young Black Sexual Minority Men with HIV (YBSMM+) in the US South: A Multi-Group Analysis of Mood, Intimate Partner Violence, and Alcohol Use.

Young Black Sexual Minority Men with HIV (YBSMM+) in the US South encounter multiple socio-structural challenges that contribute to disproportionately poor HIV-related outcomes across the care continuum. Depression, anxiety, intimate partner violence (IPV), and alcohol use are prominent factors that negatively impact engagement with HIV care. Syndemic theory posits that these multiple factors interact synergistically to promote poor outcomes; however, depression itself is highly heterogeneous in presentation, which may pose issues when examining associations to HIV care engagement.

Facilitators and barriers to effective scale-up of an evidence-based multilevel HIV prevention intervention.

Background: Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple, it is important to examine processes that occur in the translation of the EBIs into practice that affect successful implementation. The goal of this paper is to examine facilitators and barriers to effective implementation that arose among 72 community-based organizations as they moved into practice a multilevel HIV prevention intervention EBI, the Mpowerment Project, for young gay and bisexual men.

Methods: CBOs that were implementing the Mpowerment Project participated in this study and were assessed at baseline, and 6-months, 1 year, and 2 years post-baseline.

An intervention to help community-based organizations implement an evidence-based HIV prevention intervention: the Mpowerment Project technology exchange system.

Considerable resources have been spent developing and rigorously testing HIV prevention intervention models, but such models do not impact the AIDS pandemic unless they are implemented effectively by community-based organizations (CBOs) and health departments. The Mpowerment Project (MP) is being implemented by CBOs around the U.S.