Evidence map›Paper›PMID 40835912›Full record

Trial reportBMC public health2025

The effect of an economic empowerment and relationship strengthening intervention on food insecurity among couples living with HIV in Malawi.

Joshua Kiyingi, Fred M Ssewamala, Torsten B Neilands, Scott Tebbetts, Nancy Mulauzi, James Mkandawire, Amy A Conroy

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joshua KiyingiDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA. Joshua.kiyingi@ucsf.edu.
Fred M SsewamalaBrown School, Washington University, St. Louis, MO, USA.
Torsten B NeilandsDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA.
Scott TebbettsDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA.
Nancy MulauziInvest in Knowledge, Zomba, Malawi.
James MkandawireInvest in Knowledge, Zomba, Malawi.
Amy A ConroyDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA.

Funding

An economic and relationship-strengthening intervention for HIV-affected couples who drink alcohol in Malawi - Administrative SupplementR34AA027983 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CONROY, AMY ANNE · 2019 to 2022
$784k
NIAAA NIH HHS R34 AA027983U.S. National Institutes of Health 34-AA027983
6 · The paper itself

Abstract

backgroundPeople living with HIV (PLHIV) are highly impacted by food insecurity through pathways including poor adherence to antiretroviral therapy and inadequate nutrition. Limited evidence exists on whether economic empowerment interventions can improve food insecurity among PLHIV in sub-Saharan Africa. We evaluated the effectiveness of Mlambe, an economic empowerment and relationship-strengthening intervention, on food insecurity among couples living with HIV who drink alcohol in Malawi.

methodsWe analyzed data from 78 couples who participated in the Mlambe study, implemented in Zomba, Malawi. The study enrolled married couples living with HIV and unhealthy alcohol use (based on the AUDIT-C) from HIV care settings: an urban hospital, a rural private community, and a peri-urban health center. Couples were randomized into two groups: the Mlambe intervention or enhanced usual care (EUC). Mlambe intervention included incentivized savings accounts and sessions on financial literacy training and relationship skills over ten months. Study assessments occurred at baseline, 10- and 15-months. Food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS), which was categorized into four levels (food secure, mild, moderate, and severe food insecurity). We fit two-level, logistic mixed effects models testing the effect of Mlambe on severe food insecurity, given that most couples reported being food insecure.

resultsThe mean age of participants at baseline was 43.4 years, with 78.2% reporting primary education. On average, couples had been married for 13.8 years. Over half (53.3%) reported unhealthy alcohol use, 91.6% were HIV-positive, and 57.1% experienced severe food insecurity. Couples in Mlambe intervention showed a significant reduction in severe food insecurity as compared to the EUC arm at the 15-month follow-up (OR = 0.81, 95% CI: 0.66, 0.99). No significant reductions were observed at 10 months, which immediately followed the intervention period.

conclusionMlambe intervention demonstrated a significant reduction in severe food insecurity among HIV-positive couples with unhealthy alcohol use at 15-months. This pilot study provides evidence that integrated interventions targeting economic and relationship factors at household level have the potential to effectively reduce food insecurity in settings like Malawi. A full-scale efficacy study is needed to confirm findings with a larger sample and longer follow-up. STUDY CLINICAL

trial registrationMlambe was registered on ClinicalTrials.gov (NCT #04906616, 08/15/2019).

Indexed as

EmpowermentFood InsecurityHIV InfectionsInterpersonal RelationsAdultFamily CharacteristicsFemaleHumansMalawiMaleMiddle AgedCouplesEconomic empowermentFood insecurityHIVRelationship strengtheningSub-Saharan AfricaUnhealthy alcohol use

Identifiers

PMID40835912
PMCPMC12366139

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.