Shamba Maisha. (10th September 2015)

• Record Type: Journal Article
• Authors: Weiser, Sheri D.; Bukusi, Elizabeth A.; Steinfeld, Rachel L.; Frongillo, Edward A.; Weke, Elly; Dworkin, Shari L.; Pusateri, Kyle; Shiboski, Stephen; Scow, Kate; Butler, Lisa M.; Cohen, Craig R.
• Is Part Of: AIDS. Volume 29:Number 14(2015)
• Publication Date: 2015-09-10
• Subjects: AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000000781
• Languages: English
• ISSNs: 0269-9370

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objectives:</title> <p>Food insecurity and HIV/AIDS outcomes are inextricably linked in sub-Saharan Africa. We report on health and nutritional outcomes of a multisectoral agricultural intervention trial among HIV-infected adults in rural Kenya.</p> </sec> <sec> <title>Design:</title> <p>This is a pilot cluster randomized controlled trial.</p> </sec> <sec> <title>Methods:</title> <p>The intervention included a human-powered water pump, a microfinance loan to purchase farm commodities, and education in sustainable farming practices and financial management. Two health facilities in Nyanza Region, Kenya were randomly assigned as intervention or control. HIV-infected adults 18 to 49 years' old who were on antiretroviral therapy and had access to surface water and land were enrolled beginning in April 2012 and followed quarterly for 1 year. Data were collected on nutritional parameters, CD4<sup>+</sup> T-lymphocyte counts, and HIV RNA. Differences in fixed-effects regression models were used to test whether patterns in health outcomes differed over time from baseline between the intervention and control arms.</p> </sec> <sec> <title>Results:</title> <p>We enrolled 72 and 68 participants in the intervention and control groups, respectively. At 12 months follow-up, we found a statistically significant increase in CD4<sup>+</sup> cell counts (165 cells/μl, <italic>P</italic> < 0.001) and proportion virologically suppressed in the intervention arm compared with the control arm (comparative improvement in proportion of 0.33 suppressed, odds ratio 7.6, 95% confidence interval: 2.2–26.8). Intervention participants experienced significant improvements in food security (3.6 scale points higher, <italic>P</italic> < 0.001) and frequency of food consumption (9.4 times per week greater frequency, <italic>P</italic> = 0.013) compared to controls.</p> </sec> <sec> <title>Conclusion:</title> <p>Livelihood interventions may be a promising approach to tackle the intersecting problems of food insecurity, poverty and HIV/AIDS morbidity.</p> </sec> </abstract>