# Assessing the effects of a multisectoral agricultural intervention on the reproductive and sexual health of adolescent girls and young women

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $933,153

## Abstract

PROJECT SUMMARY/ABSTRACT:
In Kenya, HIV incidence among adolescent girls and young women (AGYW) ages 15-24 years is 1-2 per 100
person-years and approximately 30% of AGYW have had at least one sexually transmitted infection (STI).
Kisumu, Homa Bay, and Migori counties in Western Kenya have the highest HIV/STI incidence in the country.
Food insecurity (Fl) and poverty are also highly prevalent in Western Kenya. Fl and poverty are important
drivers of vulnerability to HIV and STls among AGYW. Poverty alleviation interventions have the potential to
reduce STls and HIV risk among AGYW but, to date, these interventions have reported mixed findings on
HIV/STI outcomes, have been primarily targeted at the individual level, and none have focused on agriculture
or Fl. Therefore, there remains a critical need to develop sustainable, multi-level, economic and Fl
interventions that improve AGYW STI/HIV prevention outcomes. Our team has successfully developed a
household-level agricultural intervention in Western Kenya called Shamba Maisha ("farm life" in Kiswahili; SM)
to reduce household Fl. In our prior pilot study with AGYW, we found that SM was feasible, acceptable, and
associated with less Fl and improved mental health. In this proposal, we will build upon our promising SM work
by examining the effectiveness and implementation of our SM intervention, including provision of a water pump
and agricultural implements for use at home, training in farming agriculture delivered at school-based
demonstration farms, and adolescent-caregiver relationship strengthening training. We plan to conduct this
school- and home-based cluster randomized trial with 800 AGYW and their primary caregivers recruited from
schools in Kisumu, Homa Bay, and Migori counties. We will randomize 20 schools in Western Kenya to
intervention or control conditions and follow AGYW-caregiver dyads for 18 months with surveys and
STl/pregnancy testing to assess intervention impacts. In Aim 1, we will determine the impact of SM on
adolescent HIV prevention and sexual and reproductive health outcomes (primary outcome is gonorrhea
and/or chlamydia incidence). In Aim 2, we will assess the effect of SM on intermediate outcomes theorized
from our published conceptual framework to be on the causal pathway, including household food security and
wealth, and adolescent and caregiver factors including mental health and aspects of the caregiver-AGYW
relationship dyad (e.g., communication). In Aim 3, we will identify critical implementation facilitators and
barriers influencing SM effectiveness and delivery and conduct a programmatic cost assessment. We will also
evaluate the extent to which SM can have "spillover'' nutritional benefits for a larger population of adolescents
who had access to demonstration farms at intervention schools but did not receive other aspects of the
intervention. Our ultimate goal is to provide an innovative household-level intervention to halt the cycle of Fl,
and poor HIV-relate...

## Key facts

- **NIH application ID:** 11008766
- **Project number:** 1R01MH138256-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Maricianah Atieno Onono
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $933,153
- **Award type:** 1
- **Project period:** 2024-08-01 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11008766

## Citation

> US National Institutes of Health, RePORTER application 11008766, Assessing the effects of a multisectoral agricultural intervention on the reproductive and sexual health of adolescent girls and young women (1R01MH138256-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11008766. Licensed CC0.

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