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BackgroundFood insecurity is an important underlying driver of HIV risk and vulnerability among adolescents in sub-Saharan Africa. In this region, adolescents account for 80% of all new HIV infections. The primary purpose of this analysis is to understand perceived mechanisms for how a multisectoral agricultural intervention influenced sexual risk taking among HIV-affected adolescents in southwestern Kenya.MethodsWe conducted semi-structured, individual interviews with 34 adolescent-caregiver dyads who were participants in Adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in the Shamba Maisha trial (NCT01548599), a multi-sectoral agricultural and microfinance intervention. Interviews were audiotaped, transcribed, translated, and analyzed using framework and interpretive description analysis methods.ResultsAdolescents receiving the Shamba Maisha intervention described no longer needing to engage in transactional sex or have multiple concurrent sexual partners as a way to meet their basic needs, including food. Key mechanisms for these effects include greater sexual agency among adolescent girls, and increased confidence and self-efficacy in overcoming existing reciprocity norms and sexual relationship power inequity; as well as staying in school. The intervention also increased caregiver confidence in talking about adolescent sexual reproductive health issues. In contrast, driven primarily by the need for food and basic needs, girls in the control arms described engaging in transactional sex, having multiple sexual partners, being unable to focus in school, getting pregnant or becoming HIV infected.ConclusionThese findings emphasize the need to address food insecurity as a part of structural interventions targeting adolescent HIV risk in low-resource countries. We recommend that future interventions build upon the Shamba Maisha model by combining sustainable agricultural production, with household level interventions that deliberately target gender norms that contribute to unequal power dynamics.

Using qualitative methods within post-structural theory, this paper questions how women make sense of their sexuality within the context of university life. I examine what relationship to sexuality women bring to college, how they negotiate their sexual agency within a university setting, and the emotional work they undertake. As the first opportunity where students live and learn independently of authoritative figures, the site provides space to explore women’s negotiation and resistance to different forms of authority. College is a particular discursive environment for regulating ideas of sex as it is a contested space of limitations and new freedoms. This cultural analysis uses data from open-ended, semi-structured interviews and focus groups with white women from multiple class positions at a small, public, doctoral-granting university in the Northeast. The participants ranged from sophomores to seniors; one identified as bi-sexual, and the remainder as heterosexual.Analyzing the sexual discourse that women employ with each other in these conversations allows us to interrogate how women’s sexual experiences are regulated for them and by others in a patriarchal society. Women perform emotional labor when discerning how they “feel” about the situation compared to how others (e.g. parents, friends, partners) “feel” about their decisions. The paper theorizes the “emotional labor” embedded within their discourse and how it informs women’s sexual decisions. I argue that “emotional labor” takes precedence over women’s desires as they work to position themselves sexually in college. This paper exposes, engages and de-constructs the boundaries that hinder women’s sexual agency.