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Sexually Transmitted Infection (STI)Vijana ShambaNCT06953310

Assessing the Effects of a Multisectoral Agricultural Intervention on the Reproductive and Sexual Health of Adolescent Girls and Young Women

A study of Sexually Transmitted Infection (STI) and HIV, run by University of California, San Francisco at 1 site in Kenya.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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 and Migori counties in Western Kenya have some of the highest HIV/STI incidence in the country. Read more about this study

Who is it for?
Ages 15 years and olderHealthy volunteers can take part
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
900 participants
Where
1 siteKenya
Study dates
20 May 2025to 30 May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Adolescent Girls and Young women (AGYW):
  • AGYW assigned female at birth
  • Between 15-19 years of age at enrollment
  • Attending the selected schools with at least 18 months remaining of schooling
  • STI-uninfected and not pregnant at baseline
  • Has an adult caregiver willing to participate
Show all 12Show fewer
  • Demonstrates moderate to severe FI based on the Household Food Insecurity Access Scale (HFIAS), and/or malnutrition (BMI less than two standard deviations below the mean for age-specific BMI
  • Caregiver:
  • At least 18 years old.
  • At least 1 AGYW aged 15-19 years old attending the selected schools
  • household has access to farming land
  • household has available surface water in the form of lakes, rivers, ponds, or shallow wells (home is 200m from permanent water source)

Who cannot join

  • AGYW or adult caregivers who have inadequate cognitive and/or hearing capacity to complete planned study procedures
  • AGYW or adult caregivers who do not speak Dholuo, Kiswahili, or English
  • Married AGYW and those who serve as heads of households
  • AGYW who are pregnant at screening
  • Adolescent girls who test positive for gonorrhea or chlamydia at screening will be invited to re-screen at least 14 days after receiving treatment and will be eligible to enroll if they have a confirmatory negative STI test.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Rachel L Burger, MHS contact

415-535-2650

rachel.burger@ucsf.edu

Jennifer Velloza, PhD, MPH contact

917-392-3561

jvelloza@uw.edu

Kenya1 site, 1 recruiting
  • Kenya Medical Research Institute (KEMRI)

    Kisumu

    Maricianah Onono, MBChB, MS, PhD, +254732390992, maricianah@gmail.com

    Elly Weke, MS, 254718441874, otielly@yahoo.com

    Recruiting

Other trials in Kenya

About this study

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 and Migori counties in Western Kenya have some of the highest HIV/STI incidence in the country. Food insecurity (FI) and poverty are also highly prevalent in Western Kenya. FI and poverty are important drivers of vulnerability to HIV and STIs among AGYW. Poverty alleviation interventions have the potential to reduce STIs 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 FI. Therefore, there remains a critical need to develop sustainable, multi-level, economic and FI 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 FI. In our prior pilot study with AGYW, the investigators found that SM was feasible, acceptable, and associated with less FI and improved mental health. In this proposal, the investigators 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 agriculture delivered at school-based demonstration farms, and adolescent-caregiver relationship strengthening training. The investigators plan to conduct this school- and home-based cluster randomized trial with 800 AGYW and their primary caregivers recruited from schools in Kisumu and Migori counties. The investigators will randomize 20 schools in Kisumu and Migori in a 1:1 ratio to intervention or control conditions and follow AGYW-caregiver dyads for 18 months with surveys and STI/pregnancy testing to assess intervention impacts. The study has the following aims: Aim 1. Determine the impact of SM on adolescent HIV prevention and sexual and reproductive health outcomes (primary outcome is gonorrhea and/or chlamydia incidence). Aim 2. 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). Aim 3. Identify critical implementation facilitators and barriers influencing SM effectiveness and delivery and conduct a programmatic cost assessment. The investigators 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. The ultimate goal is to provide an innovative household-level intervention to halt the cycle of FI, and poor HIV-related outcomes among vulnerable populations including AGYW, consistent with the "Ending the HIV Epidemic".

Being tested
Shamba Maisha
Keywords
multisectoral agriculture intervention, sexual and reproductive health, Kenya, adolescent girls and young women, HIV, food insecurity, Shamba Maisha
Medical subject headings
Sexually Transmitted Diseases, Psychological Well-Being, Coitus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Shamba MaishaOther

    The Shamba Maisha Intervention intervention has three key parts:

    Farming Equipment and Training: The study will provide families with water pumps, seeds, and other farming tools to improve their ability to grow food. Caregivers and girls will also get training on how to use these tools.

    School-based Farming: Girls will participate in practical farming activities at school, where they can learn and practice the farming skills. This also benefits the entire school because the crops grown can be used to provide food for students.

    Caregiver and Adolescent Relationship Strengthening: Families will take part in special sessions where they will learn how to improve their communication, reduce stress, and talk about important topics like sexual health.

Study groups in NCT06953310
Study groupRoleWhat they receive
Shamba Maisha InterventionExperimentalThe Shamba Maisha Intervention inervention has three key parts: 1. Farming Equipment and Training: The study provide families with water pumps, seeds, and other farming tools to improve their ability to grow food. Caregivers and girls will also get training on how to use these tools. 2. School-based Farming: Girls will participate in practical farming activities at school, where they can learn and practice the farming skills. This also benefits the entire school because the crops grown can be used to provide food for students. 3. Caregiver and Adolescent Relationship Strengthening: Families will take part in special sessions where they will learn how to improve their communication, reduce stress, and talk about important topics like sexual health.
Receives: Other: Shamba Maisha
Control ArmNo interventionControl participants and schools randomized to the control condition will have the opportunity to receive the full intervention at the conclusion of data collection.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. STI Incidence (gonorrhea and/or chlamydia incidence)

    Biologic samples

    Measured: 0, 6, 12, and 18 months

  2. Food insecurity - Household Food Insecurity Access Scale (HFIAS).

    Household Food Insecurity Access Scale (HFIAS). Scores ranges from 0-27, with higher scores indicating higher food insecurity.

    Measured: 0, 6, 12, 18 months

  3. Depression among adolescents - Patient Health Questionnaire - 9 (PHQ-9)

    Patient Health Questionnaire - 9 (PHQ-9) among adolescents. Scores range from 0 - 27, with higher scores indicating more severe depression.

    Measured: 0, 6, 12, and 18 months

Secondary outcomes (9)
  1. Body Mass Index (BMI) among adolescents

    Body Mass Index (BMI) among adolescents

    Measured: 0, 6, 12, 18 months

  2. Depression among caregivers - Patient Health Questionnaire - 9 (PHQ-9)

    Patient Health Questionnaire - 9 (PHQ-9) among caregivers. Scores range from 0 - 27, with higher scores indicating more severe depression.

    Measured: 0, 6, 12, 18 months

  3. Anxiety among adolescents - General Anxiety Disorder-7 (GAD-7)

    General Anxiety Disorder-7 (GAD-7) among adolescents. Scores range from 0 - 21, with higher scores indicating more severe anxiety.

    Measured: 0, 6, 12, 18 months

  4. Pregnancy rate among adolescents

    Pregnancy rate among adolescents

    Measured: 0, 6, 12, 18 months

  5. Percent of sexually active adolescents who self-report condom use

    Percent of sexually active adolescents who self-report condom use

    Measured: 0, 6, 12, 18 months

  6. WHO Domestic Violence Module - Intimate Partner Violence among adolescents

    WHO Domestic Violence Module. Includes physical violence, sexual violence, and emotional abuse. Scores range from 0 to 52 with higher scores indicating more violence.

    Measured: 0, 6, 12, 18 months

  7. Parent-child communication

    Parent-child communication: Families Matter! Program Tool

    Measured: 0, 6, 12, 18 months

  8. Empowerment (Self-esteem) among adolescents - Rosenberg Self-Esteem Scale (RSES)

    The Rosenberg Self-Esteem Scale (RSES). The scale ranges from 0-30, with higher scores indicating higher self-esteem.

    Measured: 0, 6, 12, 18 months

  9. Educational attainment among adolescents

    Self-Reported School attendance

    Measured: 0, 6, 12, 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 May 2025
  2. Study start20 May 2025
  3. Primary completion30 May 2028 (estimated)
  4. Study completion30 May 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
900 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06953310
Sponsor's protocol ID
1R01MH138256
Other IDs
R01MH138256
Acronym
Vijana Shamba
Status last verified
Oct 2026
First submitted
17 Apr 2025
Last updated
8 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The investigators will share individual participant data (IPD) in The National Institute of Mental Health Data Archive (NDA) and the SAP and source code will be available in a GitHub repository.

Publications

  • Cohen CR, Weke E, Frongillo EA, Sheira LA, Burger R, Mocello AR, Wekesa P, Fisher M, Scow K, Thirumurthy H, Dworkin SL, Shade SB, Butler LM, Bukusi EA, Weiser SD. Effect of a Multisectoral Agricultural Intervention on HIV Health Outcomes Among Adults in Kenya: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2022 Dec 1;5(12):e2246158. doi: 10.1001/jamanetworkopen.2022.46158.

    PubMed 36508217
  • Onono MA, Sheira L, Frongilio EA, Odhiambo G, Wekesa P, Conroy A, Bukusi EA, Cohen CR, Weiser SD. Effect of improving food security on parenting practices and caregiver-adolescent relationships: qualitative findings of an income-generating agricultural intervention in rural Kenya. BJPsych Open. 2024 Dec 26;11(1):e10. doi: 10.1192/bjo.2024.802.

    PubMed 39721953
  • Onono MA, Frongillo EA, Sheira LA, Odhiambo G, Wekesa P, Conroy AA, Cohen CR, Bukusi EA, Weiser SD. Links between Household-Level Income-Generating Agricultural Intervention and the Psychological Well-Being of Adolescent Girls in Human Immunodeficiency Virus-Affected Households in Southwestern Kenya: A Qualitative Inquiry. J Nutr. 2023 Dec;153(12):3595-3603. doi: 10.1016/j.tjnut.2023.10.008. Epub 2023 Oct 18.

    PubMed 37863268
  • Onono MA, Odhiambo G, Sheira L, Conroy A, Neilands TB, Bukusi EA, Weiser SD. The role of food security in increasing adolescent girls' agency towards sexual risk taking: qualitative findings from an income generating agricultural intervention in southwestern Kenya. BMC Public Health. 2021 Nov 6;21(1):2028. doi: 10.1186/s12889-021-12051-6.

    PubMed 34742285

Questions about this trial

What is this clinical trial studying?

A study of Sexually Transmitted Infection (STI) and HIV, run by University of California, San Francisco at 1 site in Kenya.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 8 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Kenya. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Rachel L Burger, MHS (415-535-2650, rachel.burger@ucsf.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

STI Incidence (gonorrhea and/or chlamydia incidence) (time frame: 0, 6, 12, and 18 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06953310, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Oct 2026.

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