# Leveraging Agriculture and Uniting Communities to Improve HIV Outcomes in Senegal

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2020 · $267,313

## Abstract

PROJECT SUMMARY
Innovative strategies are needed to improve progress towards the UNAIDS 90-90-90 targets in West Africa1.
Among the 5 million people living with HIV (PLHIV) in West and Central Africa in 2018, 64% knew their HIV
status, 51% were receiving antiretroviral therapy (ART), and 39% had suppressed viral loads2. Although 13%
of PLHIV globally live in West and Central Africa, 21% of AIDS-related deaths in 2018 occurred in the region.
Addressing weaknesses along the entire continuum of care, including barriers to sustained ART and viral
suppression, is critical to interrupting transmission, preventing mortality, and ending the HIV epidemic. Our
previous work has shown that the majority of PLHIV in Senegal are food insecure and that food insecurity is
associated with poor HIV outcomes. Food insecurity can contribute to increased risk of HIV acquisition through
high-risk behaviors and coping strategies. Food insecurity is a barrier to retention in care. In our K23
longitudinal study conducted among HIV-positive individuals initiating ART in Senegal, food insecurity was an
independent predictor of loss to follow-up. Food insecurity is also associated with poor adherence to ART,
which increases risk of virologic failure, HIV transmission, drug resistance, and death. The high prevalence of
food insecurity among PLHIV in Senegal and its role as a driver of poor outcomes across the HIV care
cascade, suggest that strategies to address food insecurity will be critical to achieving the 90-90-90 targets and
ending the HIV epidemic. The Casamance, located in the south of Senegal, has been the most severely
affected by the HIV epidemic and has the highest prevalence of food insecurity in the country. In collaboration
with Development in Gardening, the Service des Maladies Infectieuses et Tropical, Centre Hospitalier
Universitaire de Fann, and the Centre de Santé de Ziguinchor, we recently received funding to implement a
clinic and community based agriculture program targeting PLHIV in Ziguinchor, located in the Casamance. In
the proposed study, we will build upon findings from our K23 study of HIV, malnutrition, and food insecurity,
and leverage our recently funded agriculture program, to evaluate the impact of a multisectoral agriculture
intervention on HIV outcomes in the Casamance region of Senegal. The AIMS of this study are, AIM 1:
Determine if participation in a multisectoral agriculture intervention is associated with improved HIV outcomes
compared to the standard of care, AIM 2: Determine if participation in a multisectoral agriculture intervention is
associated with improved food security and nutritional status among PLHIV compared to the standard of care,
and AIM 3: Understand the impact of food insecurity on the behaviors and experiences of PLHIV and
determine patient perceptions of a multisectoral agriculture intervention implemented in the Casamance region
of Senegal.

## Key facts

- **NIH application ID:** 10078557
- **Project number:** 1R21AI154990-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Noelle Angelina Benzekri
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $267,313
- **Award type:** 1
- **Project period:** 2020-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10078557

## Citation

> US National Institutes of Health, RePORTER application 10078557, Leveraging Agriculture and Uniting Communities to Improve HIV Outcomes in Senegal (1R21AI154990-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10078557. Licensed CC0.

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