Agricultural intervention for food security and HIV healthoutcomes in Kenya

肯尼亚粮食安全和艾滋病毒健康结果的农业干预

基本信息

批准号：
9064868
负责人：
CRAIG R COHEN
金额：
$ 96.84万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-05-07 至 2020-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9064868
关键词：
AIDS/HIV problem Accounting Address Adult Africa South of the Sahara Agriculture Behavioral CD4 Lymphocyte Count Caring Characteristics Child Clinic Clinical Comorbidity Cost Effectiveness Analysis Country Data Development Diet Disease Education Effectiveness of Interventions Enrollment Epidemic Evaluation Family Sizes Farming environment Female Fertilizers Food Funding Future Gender Goals Growth HIV Health Health Status Health care facility Hip region structure Hospitalization Household Human Hunger Immunologics Income Individual International Intervention Intervention Trial Kenya Lead Life Mediator of activation protein Mental Depression Mental Health Methods Modeling Morbidity - disease rate National Institute of Mental Health Nutritional Nutritional status Occupational activity of managing finances Outcome Participant Pathway interactions Patients Pesticides Pilot Projects Population Poverty Process Pump Randomized Randomized Controlled Trials Risk Route Rural Population Sampling Seeds Staging Support Groups Technology Testing Theoretical model Treatment Failure United States National Institutes of Health Viral Load result Water Work antiretroviral therapy arm base behavioral outcome combat cost cost effective cost effectiveness disability-adjusted life years economic indicator empowerment experience farmer follow-up food security health economics high risk improved improved outcome intervention effect mortality physical conditioning prevent primary outcome response scale up secondary outcome therapy adherence transmission process

AIDS/HIV problem Accounting Address Adult Africa South of the Sahara Agriculture Behavioral CD4 Lymphocyte Count Caring Characteristics Child Clinic Clinical Comorbidity Cost Effectiveness Analysis Country Data Development Diet Disease Education Effectiveness of Interventions Enrollment Epidemic Evaluation Family Sizes Farming environment Female Fertilizers Food Funding Future Gender Goals Growth HIV Health Health Status Health care facility Hip region structure Hospitalization Household Human Hunger Immunologics Income Individual International Intervention Intervention Trial Kenya Lead Life Mediator of activation protein Mental Depression Mental Health Methods Modeling Morbidity - disease rate National Institute of Mental Health Nutritional Nutritional status Occupational activity of managing finances Outcome Participant Pathway interactions Patients Pesticides Pilot Projects Population Poverty Process Pump Randomized Randomized Controlled Trials Risk Route Rural Population Sampling Seeds Staging Support Groups Technology Testing Theoretical model Treatment Failure United States National Institutes of Health Viral Load result Water Work antiretroviral therapy arm base behavioral outcome combat cost cost effective cost effectiveness disability-adjusted life years economic indicator empowerment experience farmer follow-up food security health economics high risk improved improved outcome intervention effect mortality physical conditioning prevent primary outcome response scale up secondary outcome therapy adherence transmission process

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项目摘要

DESCRIPTION (provided by applicant): Despite major advances in care and treatment for those living with HIV, morbidity and mortality among people living with HIV/AIDS (PLHIV) remain unacceptably high in sub-Saharan Africa (SSA), largely due to the parallel challenges of poverty and food insecurity. Food insecurity and poverty contribute to higher morbidity and mortality among PLHIV, and there has been increasing international recognition of the need to address these factors for a successful global response to the HIV epidemic. Yet, to date there have been few studies to systematically evaluate the impact and cost-effectiveness of promising food security interventions on health outcomes among PLHIV. To address these gaps, together with KickStart, a non-governmental organization based in SSA, we have developed a multisectoral intervention in Nyanza Region, Kenya that includes: a) a microfinance loan (~$175) for purchasing agricultural implements and commodities; b) agricultural implements to be purchased with the loan including a human-powered water pump, seeds, fertilizers and pesticides; and c) education in financial management and sustainable farming practices. We successfully completed an NIH- funded pilot intervention trial that showed that the intervention was feasible, acceptable and may improve HIV- related health. We now plan to conduct a cluster randomized controlled trial (RCT) of this intervention with the following specific aims: Ai 1: To determine the impact of a multisectoral agricultural intervention among HIV- infected farmers on ART on HIV clinical outcomes. We hypothesize that the intervention will lead to improved viral load suppression (primary outcome) and decreased HIV-related morbidity in the intervention arm

描述（由适用提供）：尽管艾滋病毒/艾滋病患者（PLHIV）的艾滋病毒患者在护理和治疗方面取得了重大进展，在撒哈拉以南非洲（SSA）中，遭受艾滋病毒/艾滋病（PLHIV）的死亡率仍然很高，这在很大程度上是由于贫困和食品不稳定的平行挑战。粮食不安全和贫穷有助于PLHIV的发病率和死亡率更高，并且国际上对解决这些因素的需求越来越多，以成功地解决全球对艾滋病毒流行的反应。然而，迄今为止，很少有研究可以系统地评估承诺的粮食安全干预对PLHIV健康结果的影响和成本效益。为了解决这些差距，以及位于SSA的非政府组织Kickstart，我们在肯尼亚Nyanza地区开发了多部门干预措施，其中包括：a）用于购买农业实施和商品的小额信贷贷款（〜175美元）； b）将使用贷款购买的农业实施，包括人供水的水泵，种子，肥料和农药； c）财务管理和可持续农业实践的教育。我们成功完成了一项由NIH资助的试点干预试验，该试验表明该干预措施是可行的，可接受的，并且可以改善与HIV相关的健康。现在，我们计划以以下具体目的进行此干预措施的簇随机对照试验（RCT）：AI 1：确定艾滋病毒感染的农民对ART对HIV临床结果的多部门农业干预的影响。我们假设干预措施将导致病毒负荷抑制（主要结果）和干预组中与HIV相关的发病率的提高