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A Qualitative Investigation of the Impact of a Livelihood Intervention on Gendered Power and Sexual Risk Behaviors Among HIV-Positive Adults in Rural Kenya

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An Erratum to this article was published on 29 August 2016

Abstract

Despite the recognized links between food insecurity, poverty, and the risk of HIV/AIDS, few randomized trials have evaluated the impact of livelihood interventions on HIV risk behaviors. The current study draws upon data collected from a qualitative process evaluation that was embedded into a pilot randomized controlled trial that tested whether a multisectoral agricultural intervention (Shamba Maisha) affected the HIV-related health of HIV-positive adults in rural Kenya. In the current study, we drew upon longitudinal, in-depth interviews with 45 intervention participants and nine control participants (N = 54) in order to examine the impacts of the intervention on gendered power and sexual risk reduction among both women and men. Female and male participants in the intervention described positive changes in sexual practices and gendered power dynamics as a result of intervention participation. Changes included reduced sexual risk behaviors, improved gender-related power dynamics, and enhanced quality of intimate relationships. These findings illuminate how a multisectoral agricultural intervention may affect inequitable gender relations and secondary transmission risk. Further research is needed to explore how to best leverage agricultural interventions to address the important intersections between poverty and inequitable gender relations that shape HIV risks.

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Acknowledgments

We thank the women and men who generously gave their time to participate in the study. We acknowledge the important support of KEMRI and FACES. We gratefully acknowledge the Director of KEMRI and the Director of KEMRI’s Centre for Microbiology for their support in conducting this research. We also thank the Stephen Kodish, Kevin Kadede, Priscah Owato, Pamela Kimwele, Gina Clark, Lee Lemus Hufstedler, and Menali Nekkanti for their important contributions to this research.

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  1. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA

    Jennifer M. Zakaras, Abigail M. Hatcher, Rachel L. Burger & Craig R. Cohen

  2. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Sheri D. Weiser

  3. Center of Expertise in Women’s Health and Empowerment, University of California Global Health Institute, San Francisco, CA, USA

    Sheri D. Weiser, Craig R. Cohen & Shari L. Dworkin

  4. Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa

    Abigail M. Hatcher

  5. Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya

    Elly Weke & Elizabeth A. Bukusi

  6. Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA, USA

    Shari L. Dworkin

  7. UCSF School of Nursing, 3333 California Street, LHTS #455, San Francisco, CA, 94118, USA

    Shari L. Dworkin

Authors
  1. Jennifer M. Zakaras
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  2. Sheri D. Weiser
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  3. Abigail M. Hatcher
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  4. Elly Weke
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  5. Rachel L. Burger
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  6. Craig R. Cohen
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  7. Elizabeth A. Bukusi
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  8. Shari L. Dworkin
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Corresponding author

Correspondence to Shari L. Dworkin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This study was funded by National Institute of Mental Health (Grant R34MH094215) (PIs Cohen, Weiser). Additional funding was provided by the World Food Programme and the Burke Family Foundation. The funders had no role in data collection and analysis.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s10508-016-0846-8.

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Zakaras, J.M., Weiser, S.D., Hatcher, A.M. et al. A Qualitative Investigation of the Impact of a Livelihood Intervention on Gendered Power and Sexual Risk Behaviors Among HIV-Positive Adults in Rural Kenya. Arch Sex Behav 46, 1121–1133 (2017). https://doi.org/10.1007/s10508-016-0828-x

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  • DOI: https://doi.org/10.1007/s10508-016-0828-x

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