Health and Socio-economic Impacts of Livelihoods Programs among People Living with HIV in Cambodia: A Case-Control Study

Abstract

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in the programs for at least one year. Several indicators in socio-economic situations, food security, health conditions, and psychological well-being of the cases (n= 358) and the controls (n= 329) were compared. Results: The mean of monthly income of the cases who attended the programs for three years or more was 13.6% higher than that of the controls. A significantly higher proportion of the cases reported having three meals per day, while a significantly lower proportion of them received food assistance in the past 12 months. The mean total score for frequency of occurrence also indicated less severity of food insecurity among the cases. Regarding child education, the cases reported a significantly lower rate of out-of-school children. The proportion of the cases who rated their quality of life as good was significantly higher, and they were significantly less likely to report that they felt guilty being HIV-positive persons. Regarding psychological well-being, the mean total score of depressive symptoms for the cases was significantly lower than that for the controls, and the proportion of the cases with a cut-off score smaller than 1.75, which indicated less depressive symptoms, was also significantly higher than that of the controls. Conclusions: Findings from this study portray the positive impacts of KHANA’s livelihoods programs in maintaining and upgrading the livelihoods and quality of life of PLHIV in Cambodia. With these noticeable impacts, the programs should be scaled up to support PLHIV and vulnerable households across the country.