Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya

Abstract Background Social and economic factors have considerable influence on the lives of people living with HIV (PLHIV). These factors shape their health behaviors, willingness to engage with other members of their communities for support, and ability to seek appropriate and timely treatment opti...

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Main Authors: Bishnu Bahadur Thapa, Becky Genberg, Juddy Wachira, Jon Steingrimsson, Omar Galarraga
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Global and Public Health
Subjects:
Online Access:https://doi.org/10.1186/s44263-025-00170-w
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author Bishnu Bahadur Thapa
Becky Genberg
Juddy Wachira
Jon Steingrimsson
Omar Galarraga
author_facet Bishnu Bahadur Thapa
Becky Genberg
Juddy Wachira
Jon Steingrimsson
Omar Galarraga
author_sort Bishnu Bahadur Thapa
collection DOAJ
description Abstract Background Social and economic factors have considerable influence on the lives of people living with HIV (PLHIV). These factors shape their health behaviors, willingness to engage with other members of their communities for support, and ability to seek appropriate and timely treatment options. Evidence has shown that microfinance initiatives, by providing access to credit and social networks, have the potential to help PLHIV overcome some of these barriers. The objective of this study was to understand the association between microfinance membership and viral load suppression among HIV patients. Methods We used data from the Academic Model Providing Access to Healthcare (AMPATH)-Kenya’s Group Integrated Savings for Health Empowerment (GISHE), a microfinance initiative (MFI), to study the association between GISHE participation and viral load suppression. Our longitudinal dataset consisted of a matched group of 3609 HIV patients. We examined the association between GISHE membership and viral load suppression by addressing the missing data problem with respect to the viral load count via multiple imputation. Results Our study revealed that GISHE membership was associated with increased viral load suppression (adjusted odds ratio (AOR) = 1.15; 95% confidence interval (CI), 1.03–1.29). Further, the study found that male patients were less likely to be virally suppressed (AOR = 0.85; 95% CI, 0.74–0.97), as were the patients in the most advanced disease stage (AOR = 0.71; 95% CI, 0.52–0.95). The finding that GISHE participation was associated with a greater likelihood of viral load suppression held even after addressing the missing data problem. Conclusions We conclude that GISHE-type programs hold promise as scalable interventions to combat HIV/AIDS in Kenya and other countries where the disease is a generalized epidemic.
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spelling doaj-art-9371c56e768d45c19b15663d43d7b4522025-08-20T03:27:11ZengBMCBMC Global and Public Health2731-913X2025-06-01311810.1186/s44263-025-00170-wIs membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western KenyaBishnu Bahadur Thapa0Becky Genberg1Juddy Wachira2Jon Steingrimsson3Omar Galarraga4Department of Health Services, Policy, and Practice, School of Public Health, Brown UniversityDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins UniversityDepartment of Mental Health and Behavioral Sciences, School of Medicine, Moi UniversityDepartment of Health Services, Policy, and Practice, School of Public Health, Brown UniversityDepartment of Health Services, Policy, and Practice, School of Public Health, Brown UniversityAbstract Background Social and economic factors have considerable influence on the lives of people living with HIV (PLHIV). These factors shape their health behaviors, willingness to engage with other members of their communities for support, and ability to seek appropriate and timely treatment options. Evidence has shown that microfinance initiatives, by providing access to credit and social networks, have the potential to help PLHIV overcome some of these barriers. The objective of this study was to understand the association between microfinance membership and viral load suppression among HIV patients. Methods We used data from the Academic Model Providing Access to Healthcare (AMPATH)-Kenya’s Group Integrated Savings for Health Empowerment (GISHE), a microfinance initiative (MFI), to study the association between GISHE participation and viral load suppression. Our longitudinal dataset consisted of a matched group of 3609 HIV patients. We examined the association between GISHE membership and viral load suppression by addressing the missing data problem with respect to the viral load count via multiple imputation. Results Our study revealed that GISHE membership was associated with increased viral load suppression (adjusted odds ratio (AOR) = 1.15; 95% confidence interval (CI), 1.03–1.29). Further, the study found that male patients were less likely to be virally suppressed (AOR = 0.85; 95% CI, 0.74–0.97), as were the patients in the most advanced disease stage (AOR = 0.71; 95% CI, 0.52–0.95). The finding that GISHE participation was associated with a greater likelihood of viral load suppression held even after addressing the missing data problem. Conclusions We conclude that GISHE-type programs hold promise as scalable interventions to combat HIV/AIDS in Kenya and other countries where the disease is a generalized epidemic.https://doi.org/10.1186/s44263-025-00170-wMicrofinanceHIVViral loadSocial capitalLow-income
spellingShingle Bishnu Bahadur Thapa
Becky Genberg
Juddy Wachira
Jon Steingrimsson
Omar Galarraga
Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya
BMC Global and Public Health
Microfinance
HIV
Viral load
Social capital
Low-income
title Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya
title_full Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya
title_fullStr Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya
title_full_unstemmed Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya
title_short Is membership in microfinance initiatives associated with viral load suppression among HIV patients? Evidence from western Kenya
title_sort is membership in microfinance initiatives associated with viral load suppression among hiv patients evidence from western kenya
topic Microfinance
HIV
Viral load
Social capital
Low-income
url https://doi.org/10.1186/s44263-025-00170-w
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