This study seeks to use a group-based microfinance/internal lending model to develop social capital among people with HIV in Kenya. This will create a context to deliver validated curriculum targeting intimate partner violence, positive parenting, agriculture, small business entrepreneurship, group-interpersonal therapy, and other determinants of well-being and ART adherence among people with HIV. The primary outcomes are viral suppression, ART adherence, and common mental disorders.
It is anticipated that involvement in an internal savings and lending program will create social capital among people with HIV and their guardians (in case of adolescents w HIV). This social capital accrual will be leveraged to support and disseminate social skills (i.e. positive parenting, conflict resolution), economic skills (i.e. entrepreneurship, farming), and health skills (i.e. ART adherence, retention in care to produce viral suppression). The overall outcome is improved social, health, and economic well-being.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
843
Information has been provided in the treatment arm description.
Meru County Department of Health
Maua, Meru County, Kenya
Viral Suppression
Viral suppression is measured as an undetectable viral load using standard clinic procedures.
Time frame: Change from baseline to 3 years
Anti-retroviral therapy Adherence
Anti-retroviral therapy (ART) adherence will be measured by patient report using the adherence portions of the AIDS Clinical Trial Group (ACTG) Adherence tool and by refill history.
Time frame: Change from baseline to 3 years
Depression
Depression will be measured using the Beck's Depression Inventory. Higher scores mean more depressive symptoms present.
Time frame: Change from baseline to 3 years
Anxiety
Anxiety will be measured using the Generalized Anxiety Disorder (GAD7) instrument. Higher score means more anxiety symptoms present.
Time frame: Change from baseline to 3 years
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) will be measured using the PTSD symptom scale. Higher scores mean more PTSD symptoms present.
Time frame: Change from baseline to 3 years
Group entitativity
Social cohesion (operationalized as group entitativity) will be measured using the Generalized Entitativity Measure (GEM). Higher score on this visual analogue scale means higher group entitativity.
Time frame: Change from baseline to 3 years
Intimate partner violence
Family violence will be measured using the Conflict Tactics Scale (CTS-2). Higher scale scores mean more conflict present; higher violence/coercive subscale scores mean more violence and coercion present.
Time frame: Change from baseline to 3 years
Food insecurity
Food security will be measured using the Household Food Insecurity Scale instrument. Higher scale scores mean higher food insecurity.
Time frame: Change from baseline to 3 years
Social trust
Social trust will be measured using a single validated item. This is a binary outcome with 1=presence of trust between respondent and other similar aged people with HIV.
Time frame: Change from baseline to 3 years
Expectations of mutual support
Expectation of mutual support will be measured using the a single validated item. Higher score means higher expectation of mutual support between respondent and other similar-aged people with HIV.
Time frame: Change from baseline to 3 years.
Child-guardian conflict
Child-guardian conflict will be measured using the Conflict Tactics Scale for children (CTS2-pc). Higher scale score means more conflict present; higher violence subscale scores mean more violent conflicts used.
Time frame: Change from baseline to 3 years.
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