ProMeSA: Urban Gardening and Peer Nutritional Counseling to Improve HIV Care Outcomes Among People with Food Insecurity in the Dominican Republic
The investigators are conducting a fully powered cluster randomized controlled trial (RCT) of a culturally appropriate, multicomponent intervention combining peer nutritional counseling with urban gardening among people with human immunodeficiency virus (HIV) in the Dominican Republic (DR) to assess efficacy, analyze mediators of effects, and evaluate detailed process data to inform scale-up. The study will examine the impact of the intervention on participants' HIV clinical outcomes (HIV viral load, antiretroviral therapy adherence, and HIV care retention) as well as intermediate outcomes such as food security and HIV-related stigma.
• registered at one of the 20 HIV clinics in the study;
• age 18 or older;
• having initiated ART at least 6 months ago;
• detectable viral load in the previous 12 months based on medical records and/or evidence of adherence problems (missed clinic visits, delays in picking up antiretrovirals);
• moderate or severe household food insecurity
• physically able to plant and maintain an urban garden; stable housing and space for a garden (subjectively assessed by participants after hearing a description of what is involved)
• planned residency in the local area for the duration of the study