Agricultural Intervention for Food Security and HIV Health Outcomes in Kenya (Shamba Maisha)

This project is designed to: (1) determine the impact of a multisectoral agricultural intervention among HIV-infected farmers on antiretroviral therapy (ART) on HIV clinical outcomes. The study team hypothesizes that the intervention will lead to improved viral load suppression (primary outcome) and decreased HIV-related morbidity in the intervention arm compared to the control arm, and (2) understand the pathways through which the multisectoral intervention may improve HIV health outcomes. Using a theoretical model, the team hypothesizes that the intervention will improve food security and household wealth, which in turn will contribute to improved outcomes through nutritional (improved diet quality, nutritional status), mental health (less depression, increased empowerment), and behavioral (improved ART adherence, and retention in care) pathways. The study will determine the cost-effectiveness of the intervention and obtain the information necessary to inform scale-up in Kenya and similar settings in sub-Saharan Africa. The research team hypothesizes that the intervention will be cost-effective, and that lessons learned will be translatable into successful scale up.