An agricultural livelihood intervention is associated with reduced HIV stigma among people with HIV.
AIDS
; 38(10): 1553-1559, 2024 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-38752558
ABSTRACT
OBJECTIVE:
HIV stigma undermines antiretroviral treatment (ART) adherence and viral suppression. Livelihood interventions may target drivers of negative attitudes towards people with HIV (PWH) by improving their health and strengthening their economic contributions. We examined the effects of a multisectoral agricultural livelihood intervention on HIV stigma among PWH in western Kenya.DESIGN:
Sixteen health facilities were randomly allocated (1ââ1) to intervention or control arms in Shamba Maisha , a cluster randomized controlled trial that aimed to improve HIV-related health through behavioral, mental health, and nutritional pathways.METHODS:
The intervention included a farming loan and agricultural and financial training. Participants had access to farmland and surface water and were at least 18âyears old, on ART for more than 6 months, and moderately-to-severely food insecure. We measured internalized, anticipated, and enacted HIV stigma semiannually over 2 years using validated scales. In blinded intent-to-treat analyses, we compared changes in scores over 24âmonths by study arm, using longitudinal multilevel difference-in-differences linear regression models that accounted for clustering.RESULTS:
Of 720 enrolled participants (354 intervention), 55% were women, and the median age was 40âyears [interquartile range 34-47âyears]. Two-year retention was 94%. Compared with the control arm, the intervention resulted in significant decreases ( P â<â0.001) of 0.42 points [95% confidence interval (CI) -0.52 to -0.31) in internalized stigma, 0.43 points (95% CI -0.51 to -0.34) in anticipated stigma, and 0.13 points (95% CI -0.16 to -0.09) in enacted stigma over 24âmonths.CONCLUSION:
The agricultural livelihood intervention reduced HIV stigma among PWH. Poverty-reduction approaches may be a novel strategy for reducing HIV stigma.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Estigma Social
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
AIDS
Ano de publicação:
2024
Tipo de documento:
Article