| Title: |
A livelihood intervention improved nutritional, mental health and sexual health outcomes among HIV-affected adolescents in western Kenya: results from the Shamba Maisha randomised controlled trial |
| Authors: |
Weiser, Sheri D; Sheira, Lila Aziz; Wekesa, Pauline; Zakaras, Jennifer Monroe; Frongillo, Edward A; Weke, Elly; Nagata, Jason M; Conroy, Amy A; Lightfoot, Marguerita; Neilands, Torsten B; Butler, Lisa M; Bukusi, Elizabeth A; Cohen, Craig R; Onono, Maricianah Atieno |
| Source: |
BMJ Global Health, vol 11, iss 3 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2026 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
4203 Health Services and Systems (for-2020); 4206 Public Health (for-2020); 42 Health Sciences (for-2020); Social Determinants of Health (rcdc); Nutrition (rcdc); Women's Health (rcdc); Pediatric Research Initiative (rcdc); Clinical Trials and Supportive Activities (rcdc); Violence Research (rcdc); Behavioral and Social Science (rcdc); HIV/AIDS (rcdc); Clinical Research (rcdc); Pediatric AIDS (rcdc); Violence Against Women (rcdc); Adolescent Sexual Activity (rcdc); Prevention (rcdc); Depression (rcdc); Brain Disorders (rcdc); Infectious Diseases (rcdc); Contraception/Reproduction (rcdc); Health Services (rcdc); Mental Health (rcdc); 3.1 Primary prevention interventions to modify behaviours or promote wellbeing (hrcs-rac); Reproductive health and childbirth (hrcs-hc); Mental health (hrcs-hc); Infection (hrcs-hc); 3 Good Health and Well Being (sdg); 2 Zero Hunger (sdg); Humans (mesh); Kenya (mesh) |
| Description: |
INTRODUCTION: Interventions that address household-level factors, including food insecurity (FI) and poverty, may reduce HIV risk and improve sexual and reproductive health (SRH) among adolescent girls and young women (AGYW). METHODS: This cluster randomised controlled trial in Kenya assessed AGYW living in households of adults enrolled in Shamba Maisha (SM). SM was a multisectoral agricultural livelihood intervention designed to improve HIV health. At the trial end, we used linear and logistic regressions to compare differences between the intervention and control arms in FI, and mental health among AGYW-caregiver pairs and SRH outcomes among the AGYW, accounting for clusters with robust standard errors. We also conducted a secondary analysis among 15-19 years whose caregivers were SM participants. RESULTS: The study enrolled 241 AGYW-caregiver pairs (n=131 intervention). The median age of AGYW was 15 years old (IQR: 14-17 years old). At endline, AGYW in intervention households had less FI (OR: 0.45, 95% CI 0.21 to 0.97; p=0.04), lower depressive symptomatology (OR: 0.53; 95% CI 0.24 to 1.15, p=0.11) and no difference in unprotected sex (OR: 1.16; 95% CI 0.63 to 2.16; p=0.63) compared with those in control households. In the secondary analysis, intervention AGYW had higher body mass index (β: 1.25; SE: 0.32; p=0.002), fewer symptoms of depression (OR: 0.42; 95% CI 0.21 to 0.84; p=0.01) and anxiety (OR: 0.23, 95% CI 0.05 to 1.11; p=0.07), and less sexual intimate partner violence (IPV) (OR: 0.28; 95% CI 0.08 to 0.91; p=0.03) than control AGYW. Intervention arm caregivers had less FI than those in the control arm (OR: 0.05; 95% CI 0.0047 to 0.54; p=0.014). CONCLUSIONS: An agricultural livelihood intervention among adults living with HIV improved FI, mental health and IPV outcomes among AGYW in their households. These findings will guide the scale-up of an agricultural livelihood intervention for HIV-affected households with AGYW in sub-Saharan Africa. TRIAL REGISTRATION NUMBER: NCT03741634. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt9qr213k1; https://escholarship.org/uc/item/9qr213k1; https://escholarship.org/content/qt9qr213k1/qt9qr213k1.pdf |
| DOI: |
10.1136/bmjgh-2024-016886 |
| Availability: |
https://escholarship.org/uc/item/9qr213k1; https://escholarship.org/content/qt9qr213k1/qt9qr213k1.pdf; https://doi.org/10.1136/bmjgh-2024-016886 |
| Rights: |
CC-BY-NC |
| Accession Number: |
edsbas.D60DC45D |
| Database: |
BASE |