The Impact of Land Tenure Security on a Livelihood Intervention for People Living with HIV in Western Kenya

Afkera K Daniel; Shari L Dworkin; Annie McDonough; Abigail M Hatcher; Rachel L Burger; Elly Weke; Pauline Wekesa; Elizabeth A Bukusi; George Owino; Gladys Odhiambo; Harsha Thirumurthy; Monica Getahun; Sheri D Weiser; Craig R Cohen

doi:10.1007/s10461-022-03760-z

The Impact of Land Tenure Security on a Livelihood Intervention for People Living with HIV in Western Kenya

AIDS Behav. 2023 Jan;27(1):245-256. doi: 10.1007/s10461-022-03760-z. Epub 2022 Aug 5.

Authors

Afkera K Daniel^{1

2}, Shari L Dworkin³, Annie McDonough⁴, Abigail M Hatcher^{5

6}, Rachel L Burger⁷, Elly Weke⁸, Pauline Wekesa⁸, Elizabeth A Bukusi^{8

9}, George Owino⁸, Gladys Odhiambo⁸, Harsha Thirumurthy¹⁰, Monica Getahun⁷, Sheri D Weiser¹¹, Craig R Cohen⁷

Affiliations

¹ Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. [email protected].
² Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA. [email protected].
³ School of Nursing and Health Studies, University of Washington, Bothell, Bothell, WA, USA.
⁴ Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
⁵ Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁶ School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
⁷ Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
⁸ Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
⁹ Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
¹⁰ Department of Medical Ethics and Heath Policy, Perelman School of Medicine, Philadelphia, PA, USA.
¹¹ Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA.

Abstract

Few studies have explored land access, a structural driver of health, and women's participation in livelihood interventions to improve food security and HIV outcomes. This qualitative study, embedded within Shamba Maisha (NCT02815579)-a randomized controlled trial (RCT) examining the impact of a multisectoral intervention among farmers living with HIV in western Kenya-sought to explore the influence of perceived access to and control of land on agricultural productivity, investments, and benefits. Thirty in-depth interviews (IDIs) were conducted with purposively sampled men and women, 3 to 6 months after receiving intervention inputs; data were deductively and inductively coded and analyzed. Farming practices and participation in Shamba Maisha were dependent on land tenure and participants' perceived strength of claim over their land, with participants who perceived themselves to be land insecure less likely to make long-term agricultural investments. Land tenure was influenced by a number of factors and posed unique challenges for women which negatively impacted uptake and success in the intervention. Data underscore the importance of secure land tenure for the success of similar interventions, especially for women; future interventions should integrate land security programming for improved outcomes for all.

Keywords: Food insecurity; HIV; Kenya; Land tenure; Livelihood interventions.

Publication types

Randomized Controlled Trial

MeSH terms

Agriculture
Female
HIV Infections* / prevention & control
Humans
Kenya / epidemiology
Male
Qualitative Research
Socioeconomic Factors

Abstract

Publication types

MeSH terms

Grants and funding