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A livelihood intervention improved nutritional, mental health and sexual health outcomes among HIV-affected adolescents in western Kenya: results from the Shamba Maisha randomised controlled trial

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Introduction Adolescent girls and young women (AGYW), aged 15–24 years, are disproportionately at risk of acquiring HIV in sub-Saharan Africa (SSA). Women and girls accounted for 63% of all new HIV infections in SSA in 2021, with around 4000 AGYW acquiring an infection weekly.1 Girls account for six out of seven new infections among adolescents aged 15–19, and AGYW are three times more likely to b...
The strongest version of this narrative highlights a critical gap in HIV prevention: clinic-based interventions alone cannot address the structural drivers of vulnerability among AGYW in SSA. The focus on food insecurity and poverty as upstream risk factors is well-supported by evidence, and the proposal to test household-level agricultural interventions is a logical extension of prior research. However, the narrative leans heavily on the assumption that economic empowerment at the household lev...