Livelihood Intervention Reduces Food Insecurity and Depression in HIV-Affected Kenyan AdolescentsCan improving livelihoods help HIV-affected teens feel better and safer?

BMJ global health Published March 28, 2026 Study authors: Weiser Sheri, Sheira Lila Aziz, Wekesa Pauline, Zakaras Jennifer Monroe, Frongillo Edward A, Weke El… PubMed ↗ NCT03741634 ↗ DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Implement agricultural interventions to improve food security and mental health in HIV-affected adolescents.

This cluster randomized controlled trial in Kenya evaluated the impact of a multisectoral agricultural livelihood intervention on adolescent girls and young women (AGYW) living in HIV-affected households. The study enrolled 241 AGYW-caregiver pairs, with 131 in the intervention group. The median age of AGYW was 15 years. At the end of the trial, AGYW in intervention households experienced less food insecurity (OR: 0.45, 95% CI 0.21 to 0.97; p=0.04) and lower depressive symptomatology (OR: 0.53; 95% CI 0.24 to 1.15, p=0.11) compared to the control group. There was no significant difference in unprotected sex (OR: 1.16; 95% CI 0.63 to 2.16; p=0.63). A secondary analysis of AGYW aged 15-19 years showed higher BMI (β: 1.25; SE: 0.32; p=0.002), fewer depression symptoms (OR: 0.42; 95% CI 0.21 to 0.84; p=0.01), and less sexual IPV (OR: 0.28; 95% CI 0.08 to 0.91; p=0.03) in the intervention group. Caregivers in the intervention arm also had less food insecurity (OR: 0.05; 95% CI 0.0047 to 0.54; p=0.014). These results suggest that agricultural interventions may improve food security and mental health outcomes in HIV-affected households.

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.

What this means for you:

Supporting families of HIV-affected adolescents can improve their mental health and safety.

Study Details

Study typeRct

Sample sizen = 131

EvidenceLevel 2

Follow-up180.0 mo

PublishedMar 2026

PMID41887665

TrialNCT03741634

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.

Livelihood Intervention Reduces Food Insecurity and Depression in HIV-Affected Kenyan AdolescentsCan improving livelihoods help HIV-affected teens feel better and safer?

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Livelihood Intervention Reduces Food Insecurity and Depression in HIV-Affected Kenyan AdolescentsCan improving livelihoods help HIV-affected teens feel better and safer?

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