Imagine being a teenager facing the challenges of living with HIV. A recent study in Kenya showed that an agricultural program designed to improve livelihoods made a real difference for young women in this situation. Those involved in the program experienced less food insecurity, which means they had more reliable access to food. They also reported fewer symptoms of depression and anxiety, helping them feel better overall. Importantly, these young women faced less intimate partner violence, making their relationships safer. The caregivers in the program also benefited, experiencing less food insecurity themselves. This research highlights how addressing household needs can improve the lives of adolescents affected by HIV, paving the way for healthier futures.
Can improving livelihoods help HIV-affected teens feel better and safer?
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What this means for you:
Supporting families of HIV-affected adolescents can improve their mental health and safety. What this means for you:
Supporting families of HIV-affected adolescents can improve their mental health and safety. View Original Abstract ↓
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 (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.