Owuor Patrick M, Miller Joshua D, Kanugula Samanvi S, Yeam Joohee, Collins Shalean, Obure Valeria, Arunga Titus, Otieno Phelgona, Olack Beatrice, Butler Lisa M, Bukusi Elizabeth A, Cohen Craig R, Weiser Sheri D, Young Sera L
Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA.
Department of Anthropology, Wayne State University, Detroit, MI, 48201, USA.
Heliyon. 2024 May 29;10(11):e32058. doi: 10.1016/j.heliyon.2024.e32058. eCollection 2024 Jun 15.
Greater social capital is associated with positive health outcomes and better HIV management. The ways by which social capital may influence household water insecurity (HHWI), a critical determinant of health among persons living with HIV, remain underexplored. Further, despite the importance of reliable water access and use for health and agricultural productivity, few studies have described the strategies smallholder farmers living with HIV use to manage water insecurity.
We qualitatively explored how an agricultural intervention (provision of a treadle pump for irrigation) influenced HHWI coping strategies through its impacts on social capital among smallholder farmers living with HIV in western Kenya.
In 2018, we purposively recruited participants from the study, a randomized agricultural intervention (NCT02815579) that provided irrigation pumps to improve treatment outcomes and food security among smallholder farmers living with HIV in western Kenya (n = 42). Participants shared their experiences with water insecurity through go-along and photo-elicitation interviews. Data were thematically analyzed using inductively developed codes.
Participants described diverse strategies for coping with agricultural water insecurity. Dimensions of social capital such as feelings of belonging, connectedness, and trust influenced the use of the treadle water pump and other water access behaviors. For instance, participants reported borrowing or sharing water pumps with friends and neighbors if they felt they had a good rapport. In addition, participants indicated a willingness to engage in collective activities, such as supporting the operation of the irrigation pump during planting, when they felt sufficiently connected to a larger group. Overall, individuals in the intervention arm described greater social cohesion, reciprocity, and community connectedness than those in the control arm.
The impact of an agricultural intervention on water access and use was described as being modified by social capital among female smallholder farmers living with HIV. Findings suggest that social capital may create an enabling environment for implementing strategies that improve the management and reduce the burden of HIV. Measuring these strategies and their associations with HIV outcomes may strengthen our understanding of resilience among female smallholder farmers living with HIV. The development of a coping strategies index and its use in a longitudinal study could help to identify pathways through which social capital influences health and the effectiveness of livelihood interventions.
更高的社会资本与积极的健康结果和更好的艾滋病毒管理相关。社会资本可能影响家庭用水不安全（HHWI）的方式仍未得到充分探索，而家庭用水不安全是艾滋病毒感染者健康的关键决定因素。此外，尽管可靠的用水获取和使用对健康和农业生产力很重要，但很少有研究描述感染艾滋病毒的小农户用来应对用水不安全的策略。
我们定性地探讨了一项农业干预措施（提供脚踏泵用于灌溉）如何通过对肯尼亚西部感染艾滋病毒的小农户社会资本的影响，来影响家庭用水不安全应对策略。
2018年，我们从一项随机农业干预研究（NCT02815579）中有目的地招募参与者，该研究为肯尼亚西部感染艾滋病毒的小农户（n = 42）提供灌溉泵，以改善治疗效果和粮食安全。参与者通过随行访谈和照片引发访谈分享了他们应对用水不安全的经历。使用归纳开发的代码对数据进行了主题分析。
参与者描述了应对农业用水不安全的多种策略。归属感、联系感和信任感等社会资本维度影响了脚踏水泵的使用和其他用水获取行为。例如，参与者报告说，如果他们觉得与朋友和邻居关系融洽，就会向他们借用水泵或与他们共享水泵。此外，当参与者觉得与更大的群体有足够的联系时，他们表示愿意参与集体活动，比如在种植期间支持灌溉泵的运作。总体而言，干预组的个体比对照组的个体表现出更强的社会凝聚力、互惠性和社区联系感。
一项农业干预措施对用水获取和使用的影响被描述为在感染艾滋病毒的女性小农户中受到社会资本的调节。研究结果表明，社会资本可能为实施改善艾滋病毒管理和减轻艾滋病毒负担的策略创造有利环境。衡量这些策略及其与艾滋病毒结果的关联可能会加强我们对感染艾滋病毒的女性小农户复原力的理解。制定应对策略指数并将其用于纵向研究，有助于确定社会资本影响健康的途径以及生计干预措施的有效性。
