UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Intervention Components Shamba Maisha: Qualitative Assessment of the Impacts of a Mixed Methods Randomized Control Trial Multisectoral Agricultural Livelihood and HIV-Care Intervention on Agricultural Practices, Food Security and Nutrition in Western Kenya Tammy Nicastro, primary mentor: Sheri D. Weiser UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Introduction Results Specific Aims In Western Kenya, 75% of people living with HIV (PLHIV), depend on agriculture for their livelihood and household food, making agricultural critical to health. Kenya’s HIV epidemic is the fourth largest in the world: 1.6 million PLHIV. Largest concentration of PLHIV is in Western Kenya, where food insecurity (FI) and poverty are highest. Prior studies show negative impacts of FI on new HIV infections, adherence to antiretroviral therapy (ART) and HIV outcomes. Pathways between agriculture, improvements in FI, nutrition and health has not been studied. Understanding pathways between agriculture, FI and health in this region is critical to inform policies and programs supporting PLHIV. Intervention Components Agricultural inputs: irrigation pump, seeds, fertilizer Agricultural and finance training HIV Care Both intervention and control received same HIV care To characterize participant perceptions of a multisectoral agricultural and finance intervention on agricultural practices and crop yields. To analyze perceived impacts of the agricultural intervention on participant’s food security and nutrition. To determine if participants perceive changes in their food security and nutrition as independent from changes in their crop yields during the study period. and health Methods Conclusions RCT: 45 intervention, 9 control interviewed at month 12 Secondary, longitudinal qualitative analysis of intervention and control participants’ interview transcripts Deductive-inductive approach utilizing a purposive sample Double-coded using Dedoose with broad thematic codes followed by fine-codes from sub-themes Analytic reports were used for data analysis to arrive at findings Parent study showed statistically significant improvements in HIV health outcomes, food security scores and frequency of meals Key findings from qualitative study: improvements in agricultural practices, yields, market participation and income resulted from intervention. Improvements led to community requests for agricultural training, adequate, nutritious food, and new income and savings Improvements acted as mechanisms to improved food security, nutrition and health. Participants noted separate from current yields, food security, income and health, they felt protected from future unexpected weather or economic related events because the intervention components had enduring value and could be passed down to children and other family members. Agricultural interventions can be used as a tool to improve food security and health outcomes in smallholder farmer communities.