Bridges retention rates.

Background
Youth orphaned by HIV in sub–Saharan Africa experience immense hardships including social disadvantage, adverse childhood events and limited economic prospects. These adversities disrupt the normative developmental milestones and can gravely compromise their health and emotional wellbeing. The Bridges to the Future study (2012–2018) prospectively followed 1,383 adolescents, between 10–16 years, to evaluate the efficacy and cost-effectiveness of a family-based economic empowerment intervention comprising of child development accounts, financial literacy training, family income generating activities and peer mentorship. Study findings show efficacy of this contextually-driven intervention significantly improving mental health, school retention and performance and sexual health. However, critical questions, such as those related to the longitudinal impact of economic empowerment on HIV prevention and engagement in care remain. This paper presents a protocol for the follow-up phase titled, Bridges Round 2.
Methods
The Original Bridges study participants will be tracked for an additional four years (2022–2026) to examine the longitudinal developmental and behavioral health outcomes and potential mechanisms of the effect of protective health behaviors of the Bridges cohort. The study will include a new qualitative component to examine participants’ experiences with the intervention, the use of biomedical data to provide the most precise results of the highly relevant, but currently unknown sexual health outcomes among study participants, as well as a cost-benefit analysis to inform policy and scale-up.
Discussion
Study findings may contribute to the scientific knowledge for low-resource communities on the potential value of providing modest economic resources to vulnerable boys and girls during childhood and early adolescence and how these resources may offer long-term protection against known HIV risks, poor mental health functioning and improve treatment among the HIV treatment care continuum.

### 研究背景
撒哈拉以南非洲地区因艾滋病（HIV）致孤的青少年面临诸多严峻困境，包括社会排斥、童年不良经历以及有限的经济发展前景。此类逆境会打乱个体的标准化发展里程碑，并严重损害其健康与情绪福祉。本研究团队于2012至2018年开展了‘未来之桥’（Bridges to the Future）研究，前瞻性追踪了1383名年龄在10至16岁之间的青少年，以评估一项基于家庭的经济赋权干预措施的有效性与成本效益，该干预措施涵盖儿童发展账户、金融素养培训、家庭创收活动及同伴辅导四大模块。研究结果显示，这项贴合当地情境的干预措施确实有效，可显著改善参与者的心理健康状况、在校留存率与学业表现，以及性健康水平。然而，仍存在若干关键科学问题有待解答，例如经济赋权对艾滋病预防以及诊疗参与度的长期影响等。本文旨在介绍名为‘Bridges Round 2’（未来之桥第二轮研究）的追踪阶段研究方案。

### 研究方法
本研究将对‘未来之桥’初代研究的参与者进行为期4年的追加追踪（2022至2026年），以探讨该队列群体的长期发展与行为健康结局，以及保护性健康行为发挥作用的潜在机制。本次追踪研究将新增一项质性研究模块，用以探究参与者对干预措施的体验；同时将利用生物医学数据，为该研究群体中极具相关性但目前尚未明确的性健康结局提供最精准的分析结果；此外还将开展成本效益分析，为相关政策制定与项目推广提供依据。

### 研究讨论
本研究成果或将为低收入资源社区补充相关科学认知，阐明在童年及青春早期向弱势男女孩童提供适度经济支持的潜在价值，以及此类支持如何长期抵御已知的艾滋病感染风险、改善心理健康状态，并优化艾滋病诊疗全流程中的治疗效果。