Exploring Sustainable Livelihoods Through Pierre Bourdieu’s Theory of Capital: A Strategy to Reduce Vulnerability Among Young Adults with HIV in Kisumu, Kenya

Highlights

• Community-led sustainable livelihoods are crucial for food security and health outcomes, especially for people living with HIV.
• Community social groups, such as HIV support groups, are critical to access to various types of capital, including financial, social, and cultural capital.
• Inequitable distribution of resources remains a challenge to sustainable livelihoods among young adults living with HIV.
• Improving governance within community HIV support groups is key to unlocking resources and sustainability for small-scale sustainable livelihood projects.

Abstract

Sustainable livelihoods remain a vital part of health and can significantly influence overall health outcomes. In sub-Saharan Africa, where HIV continues to affect household economic stability, small-scale but sustainable livelihood interventions have proven essential for economically vulnerable families. These economic empowerment initiatives, mainly funded by non-governmental organizations, are common across the region. Despite their important role in shaping health outcomes, there is a limited understanding of the theoretical frameworks that guide their implementation and results, especially among households affected by HIV. Using qualitative methods, we applied Pierre Bourdieu’s theory of capital to better understand how livelihood projects are implemented among young adults living with HIV in Kisumu. Our findings indicate that livelihood interventions need more than just economic capital to be successful. Social and cultural capital, for example, help overcome barriers like stigma and foster a sense of belonging, while economic capital enables start-up activities and knowledge sharing that support livelihoods. The insights from this study are important for guiding resource allocation toward economic development and social asset building as ways to leverage different types of capital.

1. Introduction

Despite major advances in HIV treatment, about forty million people worldwide are still living with HIV, with sub-Saharan Africa bearing the heaviest burden, accounting for 70% of all cases [1]. Young people, especially adolescents and young adults, make up a significant share of new HIV cases in most parts of the continent. For instance, in Kenya, the 2024 HIV Modes of Transmission (KMOT) Study Report states that in 2023, the national HIV prevalence among adults aged 15–49 was 3.3%. Young adults aged 15–24 made up over 39% of new cases. Adolescent girls and young women are especially impacted, accounting for more than 15% of the overall HIV prevalence and 10% of new infections each year [2].

Evidence suggests that the high HIV incidence among young people in the African region is mainly caused by socioeconomic and biological factors, including poverty-related issues and regressive norms like gender inequality. While several biological factors have been evaluated for their effectiveness [3,4], socioeconomic factors, especially those targeting young people, are underexplored and remain challenging. Nonetheless, some studies, such as the Shamba Maisha study in Kenya, have provided sufficient evidence to suggest that socioeconomic interventions targeting livelihoods can improve HIV treatment outcomes. These improvements include increased adherence to medication, better physical and nutritional health, and improved mental health.

As economic, political, and environmental challenges intensify, the impact of HIV on livelihoods in the region is likely to worsen. Global forces such as the cut in the US government’s funding for HIV prevention are already raising doubts about the continuity of care and are destabilizing household incomes [5]. Similarly, increasing global inflation along with unstable climate conditions endanger the safety nets that individuals and families depend on for their survival [6]. Consequently, households and communities experience greater challenges in obtaining essential needs like food, nutrition, healthcare, and other basic services.

While governments and civil society organizations (CSOs) have successfully promoted the integration of livelihood and HIV/AIDS programs among people living with HIV/AIDS (PLWHIV) [7,8], livelihood interventions have mainly focused on adults. For example, the work of Helen Keller International (HKI) in Cambodia among households of people living with HIV who engaged in food production saw increased income and food security, helping beneficiaries enhance their food and nutrition security [9]. However, this study primarily focused on adults and paid little attention to young people. While a study conducted in Rwanda found that young people participating in groups or associations of people living with HIV were most likely to experience positive health changes [10], this study did not focus on livelihoods. In Tanzania, a livelihood study showed that when People Living With HIV (PLWHIV) associations support their members with income-generating activities, financial aid, and technical assistance, they are more effective at reducing the spread of HIV [11]. Similarly, a Practical Action research project in Mozambique demonstrated that supporting income-generating activities, such as vegetable gardens, crop farming, and chicken rearing, within PLWHIV associations can enhance members’ skills and knowledge across multiple areas, including improved access to HIV care [8,12].

In Kenya, evidence indicates that involving PLWHIV in livelihood activities promotes fairer access to basic needs [8]. For example, the LIFE Project in Butula Division focused on improving the livelihoods of PLWHIV and their dependents through micro-enterprise development. This project demonstrated that engaging in economic activities and receiving integrated support can alter the negative beliefs that contribute to the exclusion of marginalized groups [13]. In Kisumu County, the impact of livelihood initiatives on reducing HIV vulnerability is evident in the numerous non-governmental organizations conducting development projects. These organizations mainly focus on supporting people living with HIV and their communities, emphasizing self-sustaining programs [14]. For example, evidence suggests that livelihood interventions by non-state actors in resource-poor regions have successfully promoted livelihoods through community-based organizations working with PLWHIV [15,16].

For more than a decade, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) projects in western Kenya have supported numerous community-led initiatives that implement economic-strengthening programs to improve livelihoods [8]. Similarly, organizations such as Plan International, Care, and World Vision, among others, have collaborated with government departments and community members to support vulnerable households with livelihood projects [17,18]. These organizations have supported business start-ups, informal micro-lending initiatives, and strengthened value addition processes [19].

Although adolescents and young people in sub-Saharan Africa face a higher HIV burden, they have been excluded from key livelihood programs with the assumption that they are less likely to take part in household income [4,20]. Moreover, until recently, efforts to address the impacts of HIV/AIDS mainly concentrated on clinical care rather than socio-economic interventions [21]. Beyond clinical implications, for adolescents and young adults living with HIV, the impact can be especially severe, causing challenges in securing employment, lowering self-esteem and productivity, and increasing caregiver responsibilities. However, despite their vital role in HIV management, understanding the theories behind their success remains limited. Therefore, guided by Pierre Bourdieu’s theory of capital [22,23], we aimed to explore the barriers and facilitators to implementing livelihood projects among People Living with HIV in the East Seme area of Kisumu County. Our study highlights Pierre Bourdieu’s theory of capital to understand livelihood projects and explore how the concept can be appropriated to improve the implementation of sustainable livelihoods. This is especially important in community projects where economic, social, and cultural capital are differently affected by societal norms, including community and family dynamics.

2. Pierre Bourdieu’s Theory of Capital

While sustainable livelihoods have been examined for their contribution to economic well-being for vulnerable populations, the use of a theoretical framework to inform these interventions has been limited. This study draws on Pierre Bourdieu’s theory of types of capital [23] to inform our understanding of the barriers and facilitators surrounding livelihood interventions for young people living with HIV. Bourdieu’s theory of capital sees an individual’s social status as a function of three different kinds of capital: economic, social, and cultural [24]. Besides considering capital solely from a financial standpoint, Bourdieu recognized that capital includes other elements such as social connections, knowledge, and cultural understanding [22]. These additional elements, he argues, are essential in shaping individuals’ positions within social structures and their interactions. From this perspective, the social world is viewed as a repository of accumulated history shaped by each type of capital. For instance, economic capital can be directly exchanged for cash and is easily formalized as property rights. In contrast, social and cultural capital are formalized as social statuses, obligations, and connections, which can sometimes be converted into economic capital. As a result, capital in all its forms plays a central role in a person’s overall well-being in society.

The importance of this theory in understanding livelihoods becomes clear when looking at the barriers and facilitators of livelihoods from the perspectives of the three forms of capital and the social world. First, the overall distribution of different types of capital at a specific time reflects society’s inherent class structure, where social worth (status and position) is determined by economic worth and vice versa. Second, while financial capital can be effectively used to improve an individual’s abilities within society, its success often relies on cultural and social capital, which can either validate or diminish its value within social networks. The amount of social capital a person has depends on the size of the network of connections they can effectively mobilize and has been demonstrated to contribute to the success of community programs. In Latin America, for example, social capital has been linked to community resilience and for building and strengthening community response [25,26]. Similarly, in Kenya, social support has shaped the kinds of relationships people forge in their communities and their agency to negotiate around their needs [12]. Therefore, capital—whether economic, social, or cultural—stems from the nature of the relationships between individuals.

Within livelihood projects, particularly those aimed at HIV prevention, various forms of capital have manifested in distinct ways. In most cases, social and cultural capital have relied heavily on membership and relationships within groups [27]. For example, membership in support groups and participation in social networks have enabled people living with HIV to acquire and access different types of capital resources [28]. However, individuals have leveraged their social connections, ranging from memberships to personal relationships, to enhance their social standing in these groups and access these resources [12]. Some studies suggest that variations in how social capital is managed within these groups may explain why equal amounts of economic and cultural capital yield different levels of profit and influence across social groups [29].

For livelihood interventions, participating in groups can build social capital and amplify other types of capital [30]. Therefore, voluntary associations among people living with HIV serve as a collective resource created and shared by members. This ability of social groups to unite aligns with Bourdieu’s view that the economic, social, and cultural benefits of group membership provide a strong basis for development [30]. In western Kenya, where this study was conducted, young people are expected to demonstrate a level of productivity through engagement in income-generating activities. However, in this resource-constrained setting, formal and informal employment remain a key challenge for most young people. In the case of those living with HIV, the challenge is exacerbated by the unique needs in managing HIV. Most of the affected could tap into their social connections as a means to create livelihood opportunities to address their immediate and societal needs. As such, the social connection groups for PLWHIV could be designed to not only address the livelihood needs of adults but also those of the younger individuals affected by HIV. Pierre Bourdieu’s theory of social capital could help map out the structures essential for addressing vulnerabilities to livelihoods in youth affected or infected by HIV.

3. Methodology

3.1. Study Site

This study was carried out with the support of Pamoja Community-Based Organization, which has been actively running various community HIV interventions in Kisumu County since 2007. Pamoja Community-Based Organization (CBO) is a grassroots, nonprofit organization in Kenya with years of experience working with rural communities to support community-based HIV prevention in Kisumu County. Pamoja established over 60 support groups to offer prevention interventions across several villages in Kisumu. Modeled as community access hubs for preventive care services, the organizations partner with the local Ministry of Health to provide services to over 16,000 adolescent and young adults. These services range from education and the provision of reproductive health services, including PrEP, contraceptives, post-violence care, and HIV testing, to social asset building, such as behavioral and socioeconomic skills, as well as livelihood projects. This study focused the evaluation of livelihood projects in East Seme Sub County, in Kisumu Kenya.

East Seme area of Seme Sub-County, about 25 km from Kisumu City. East Seme is divided into three sub-locations: Kajulu-Koker in the south, Kit-Mikayi along Kisumu Bondo Road, and Kaila in the north. The primary economic activities include farming, primarily of groundnuts, maize, and sorghum, which rely heavily on rainfall. In addition, people near the lake engage in fishing, and many young people operate bicycles and motorcycle taxis, known as boda-bodas. Although some of these seriocomic factors, such as fishing, are unique to East Seme and Kisumu County, they are shaped by broader social and economic structures in Kenya. Although Kenya is classified as a middle-income country, its unemployment rate remains relatively high, particularly among young people, who constitute the largest share of the population [31,32]. The unemployment rate in rural areas is even higher due to a lack of industries. In Kenya, most industries are concentrated in urban areas, particularly in Nairobi and nearby regions [33]. Furthermore, prevalent practices like nepotism, corruption, and favoritism—often worsened by widespread ethnic discrimination—complicate access to job opportunities [34,35]. As a result, many young people have turned to self-employment.

3.2. Study Design, Sample, and Sampling Procedures

This study used a qualitative research design because of its ability to deepen the understanding of behavior and social life within a social group [36]. Additionally, qualitative approaches provide insights into how people behave in groups, organizations, and communities, as well as how individuals perceive their actions [37].

A total of 50 individuals, including 28 women and 22 men, living with HIV and aged 18–24, were purposively selected to participate in the study from January 2023 to December 2024. Purposive sampling is a valuable qualitative method in which settings, people, or events are carefully chosen for the important information they can provide [38]. This approach effectively captures the population’s diversity, thereby enabling examination of heterogeneity, given Bourdieu’s emphasis on the unequal distribution of capital across social positions, especially social classes, exhibited in social space and informal groups [39,40]. Additionally, purposive sampling can reveal the underlying reasons for individual choices and variations in these choices, while enabling researchers to explore key cases relevant to the research questions.

Participants were recruited by trained qualitative research assistants who worked closely with peer mentors. First, peer mentors informed participants in their regular group meetings about the research activities. The peer mentors were provided with a research information sheet to ensure the information session regarding the research activity was accurate. Participants who were willing to participate were asked to contact the research assistants directly. This was deemed necessary to increase participation and avoid power dynamics between the peer mentors and the participants. The research assistants were not employees of the Pamoja CBO and had no prior contact with the participants.

Inclusion criteria: Individuals were recruited to participate in the study if they were HIV-positive, aged 18–24 years, involved in the Pamoja Community-Based Organization HIV prevention programs, and members of a community support group for people living with HIV. Additionally, participants had to be members of the group for at least 3 months and must have been involved in the organization’s HIV prevention program for at least 6 months. These were deemed adequate for individuals to acquire knowledge and experience within the organization and the groups.

3.3. Study Procedures

3.3.1. Data Collection Methods

This study employed in-depth individual interviews (IDIs) and focus group discussions FGDs). Qualitative data collection methods typically involve direct interaction with participants, either one-on-one or in group settings [41]. Although these methods are often criticized for being time-consuming and having smaller sample sizes that limit the generalization of findings, they provide richer data and a deeper understanding of the phenomena studied. Both IDIs and FGDs sessions were conducted by a trained research assistant fluent in the local language. Interviews lasted approximately 1.5 h and were audio recorded.

In-depth interviews: We conducted in-depth interviews with 35 individuals (20 women and 15 men) to explore their perspectives on livelihoods among people living with HIV. These individuals were purposively selected from PLHIV groups within the Pamoja Community-Based Organization programs. In-depth interviews were particularly valuable because they allowed the collection of detailed insights from individual thoughts and actions, providing a contextual understanding that yielded a more complete picture of the research phenomenon [42].

Focus Group Discussion: To examine group and community dynamics, as well as perspectives on livelihoods among individuals living with HIV, we recruited 15 participants (8 women and 7 men) for two separate focus group discussions, each comprising both men and women. Like IDIs, the participants for the FGDs were purposively recruited from Pamoja Community-Based Organization programs. Focus groups are interviews that gather a small, homogeneous group (typically six to twelve people) to discuss topics related to a study agenda.

3.3.2. Ethics Statement

Ethical approval for this study was obtained from the Amref Health Ethics and Scientific Research Committee (ESRC) under the protocol number AMREF-ESRC P1396/2023. Written informed consent was obtained from all participants prior to data collection.

3.3.3. Data Analysis

The audio-recorded interviews from IDIs and FGDs were first transcribed and then translated into English from Luo or Swahili, depending on the interview language. The first author then read all transcripts and listened to the interviews to ensure that no information was missing or altered during transcription. Next, using Pierre Bourdieu’s three concepts of capital—social, cultural, and economic capital—as keywords, the first author developed a coding matrix, which was then uploaded into the Atlas. TI qualitative software (ATLAS.ti 25 25.0.1) for data analysis. A coding template was then developed through a consensus process where codes developed by author one were shared and reviewed by all authors. To ensure consistency, the last author, in consultation with the first author, reread the transcripts against all applied codes. This process led to the merging of and the creation of additional sub-codes. All authors reviewed the final list of codes, which were then applied to the transcripts until all codes were used. Using thematic analysis, the three types of capital were examined, and common patterns and trends in the narratives were identified, and a detailed thematic matrix was developed.

4. Results

In this study, we aimed to explore sustainable livelihoods as a strategy to reduce vulnerability among young adults living with HIV using Pierre Bourdieu’s concept of capital. We found that the implementation of livelihood interventions among young people living with HIV in Kisumu rural areas was greatly affected by social, cultural, and economic capital. Social and cultural capital included participation in livelihood or economic strengthening programs, poor leadership within youth-led social groups, and stigma and discrimination. On the other hand, economic capital was characterized by a lack of financial resources for youth start-ups, knowledge gaps in key areas such as technology and market knowledge, and poor sustainability of start-ups.

Out of the 50 participants, 28 (56%) were women, with an average age of 20 years, slightly younger than the men, whose average age was 24. More than half of the male participants had additional time for other income-generating activities, such as working outside their homes. In contrast, only five women (17%) reported having extra time for economic activities outside their parents’ homes. Furthermore, 15 male participants (68%) reported holding leadership roles within their groups, managing financial decisions, and representing their groups externally. About 90% of male participants (n = 20) reported having a college diploma, compared with 64% of female participants. Although none of the male participants reported having children, female participants stated they had been pregnant and had a child before finishing high school. These social disparities highlight Pierre Bourdieu’s emphasis on examining heterogeneity within social groups, regardless of their apparent homogeneity.

4.1. Livelihoods and Sociocultural Capital

In this section, we outline how social and cultural capital have shaped the successes of livelihood projects among young people. We conceptualize social and cultural capital to include participation, leadership, cultural perspectives, such as stigma.

4.2. Participation in Livelihood or Economic Strengthening Programs

Participants reported that joining social groups, especially those involving income-generating activities, was difficult. Financial obligations created a sense of exclusion and shame, with most participants reporting that they dropped out or avoided joining altogether because they could not contribute. This exclusion not only undermined the social capital but also prevented them from accessing collective resources and support.

We are eager to participate in interventions that can positively impact our lives. But every time we join a group or space discussing economic activities, the money subject is brought up. Many of us shy away or drop out altogether.

(IDI, Female, 19 years old)

I recall vividly how my ideas and suggestions to the group to start saving money in a bank account rather than in a cash box were ignored. My group members said that I could not be lecturing them about money issues, yet I did not have any money to contribute. I felt horrible, so I left the group. Since then, I have not thought about joining any other group.

(IDI, Female, 19 years old)

These experiences highlight how economic capital directly influences social capital within group settings, creating imbalances that undermine the collective potential of livelihood initiatives. Young people who might offer valuable skills, energy, and innovative ideas are systematically marginalized, reducing the overall effectiveness of group activities while keeping some people left out.

4.3. Leadership in Youth-Led Social Groups

Leadership challenges emerged as a critical barrier to effective group functioning and livelihood success. Most young participants in our study expressed concerns about leadership quality within their peer groups. Some said that ongoing leadership conflicts hinder productive discussions, while others pointed out a lack of vision within many youth-led social groups. Persistent fighting and a lack of consensus were commonly noted. Participants reported that leadership positions were often sought for personal gain rather than collective benefit, with individuals motivated more by status and power than by genuine commitment to group success.

I honestly hate it when we, as young people, can’t lead. We keep trying to convince our friends to derail them. For example, in a group, I had to resign as treasurer because of constant criticism from my friends. They kept complaining that I was not doing the right thing. Now that I am out, the person who took over diverted many members of the group to his project and then left the group. I am confident that if these leadership issues can be resolved, young people will be very successful in their economic pursuits.

(IDI, Male, 21 years old)

These leadership challenges reflect broader issues in youth development and organizational capacity. Many young people, most of the time, do not receive leadership training or mentorship, making them unable to manage complex group dynamics or resolve conflicts constructively. The absence of structured leadership development programs within HIV-focused organizations further exacerbated these challenges. Participants also noted that leadership conflicts often reflect deeper tensions around resource access and decision-making authority. In places with limited resources, leadership roles were seen as chances for personal gain instead of serving the group, leading to harmful competition that weakened teamwork.

4.4. Stigma and Discrimination for Young People Living with HIV

Although most participants are young people living with HIV, many reported they cannot extend their interactions outside the group due to fear of being labeled as sick and desperate. Among our participants, stigma and discrimination were noted as present concerns for young people when venturing out. Some of them reported that they deliberately did not participate in interventions that were advertised or publicly known to be purely for people living with HIV. These interventions were thought to be too conspicuous, and anyone participating in them was regarded as HIV positive. Some participants said that in some cases, young people who were not HIV positive and wanted to be part of their groups shied away because of the labeling that came with those projects. In most cases, participants reported not being comfortable being visited by workers or representatives of big nongovernmental organizations (NGO) in their vehicles, as these would be considered a link to an HIV program. This led to an unfortunate situation in which young people who needed help the most did not get it because they were afraid of how others would react.

Having participated in support groups for young people with HIV, I’ve noted a recurring hesitation to seek support outside our circle. People outside are often unkind, sometimes talking about us or denying services once they realize our group is for people with HIV. When we began collaborating with a local organization supporting our cause, their visits with a project vehicle that clearly indicated their work with HIV-affected individuals made us uncomfortable. After several visits, no one wanted to associate with us, prompting us to change our strategy. We started holding meetings in town, where village scrutiny was less intense.

(IDI, Female, 23 years old)

These experiences demonstrate how stigma operates as a structural barrier that limits not only individual opportunities but also the effectiveness of targeted HIV programming. When stigma makes participation in HIV-focused initiatives socially costly, even well-designed programs may fail to reach their intended beneficiaries.

4.5. Livelihoods and Economic Capital

While social and cultural capital play a critical role in unlocking financial capital, our study reveals that economic capital is a prerequisite for starting any money-generating enterprise. Below, we describe how social capital plays a role in accessing financial capital, and consequently, how a lack of financial capital hinders economic ventures. In addition, we highlight how financial capital determines access to technology, market knowledge, and the sustainability of entrepreneurial ventures by young people.

4.6. Lack of Financial Resources for Youth Start-Ups

While most young people reported difficulties in participating in economic activities due to membership and other fees, including shares, some young people reported that even after paying the required fees, starting something economically viable is often a challenging task because many businesses or economic activities require substantial capital. Others noted that the shares and membership fees are often insufficient for any meaningful business. Moreover, others indicated that efforts to access credit from money lending institutions are often unsuccessful due to a lack of security. While participants appreciated the discipline and social benefits of regular savings, they recognized that small weekly contributions could not generate sufficient capital for impactful business investments within reasonable timeframes.

I remember joining the group several months ago. We contributed the registration fee, and then we were instructed to start contributing weekly shares to support the business. However, this process has been slow. Most of us cannot afford the weekly shares, and our capital remains very low, making it difficult for us to engage in any meaningful business. Recently, we approached a local bank for a loan. They wanted 6 months of revenue, a bank statement, and security for the money. Unfortunately, we still do not have these requirements, so we can’t access the loans.

(FGD, Male, 20 years old)

Attempts to access external credit proved equally challenging, with formal financial institutions imposing requirements that were impossible for young people to meet. Banks demanded extensive documentation, including business plans, revenue projections, and guarantors’ requirements that assumed existing business experience and established financial relationships. This financial exclusion reflects broader systemic issues in financial services provision for young people and marginalized populations. Microfinance institutions, while more accessible than commercial banks, often charged interest rates that made borrowing unsustainable for small-scale enterprises with uncertain returns.

4.7. Knowledge Gaps in Technology and Market

Despite high levels of mobile phone ownership and educational attainment, participants demonstrated significant gaps in technology utilization and market knowledge that constrained their livelihood potential. This was mainly due to a lack of finances to acquire smart mobile phones or internet access. Most youths we interviewed noted that they often use their phones for basic personal communications because their phones did not have internet capability to navigate sophisticated websites, or they could not afford the internet bandwidth to download or operate the websites. They also reported that they rarely engage in reading technical information about business or economic activity because of limited internet access. Instead, many reported spending their time constantly scrolling through social media posts, either reposting or liking others’ posts, an activity they said required very little data and basic internet-enabled phones to do. Additionally, the participants reported not liking lengthy texts that are plain, lack illustrations, or videos. This pattern showed that people did not know much about the resources available and preferred videos or images over reading text. For those engaged in income-generating or economic activities, marketing their products was a challenge. Where the market was available, they could not afford to wait for long days before getting paid.

Almost everyone in our group has attended college and owns a smartphone. We stay connected using various messaging apps like WhatsApp, TikTok, Facebook, Instagram, and others. However, I can spend hours just scrolling between these apps, liking or reposting content. When a post is long, people tend to dislike it, while short videos and photos are more popular. I don’t recall anyone reading extensively on their phones.

(FGD, Male, 22 years old)

This technology usage pattern represented a significant missed opportunity for changing behaviors in information dissemination, skill development, and market engagement. Participants had the tools and basic digital literacy necessary for online learning and business development, but lacked the motivation, guidance, or awareness needed to leverage these resources effectively.

4.8. Lack of Sustainability: A Barrier to Participation in Livelihood Projects

Sustainability challenges emerged as one of the most discouraging barriers for young people attempting to establish livelihood activities. Most participants recounted their involvement in unsuccessful start-ups or seen others’ projects failing. Some young people mentioned facing difficulties due to tough economic conditions, with their small businesses often struggling to turn a profit. Young people reported experiencing crop failures due to unpredictable weather, while other enterprises operate on very small profit margins, which limits their growth potential.

It’s difficult for me to envision a future for the projects we pursue as young people, especially those started by support groups. Many of us have started projects, but they often don’t last, mostly due to challenges with funding, markets, or management. Some of us have tried farming, but because they depend heavily on rainfall, they’ve faced crop failures and no longer have money to buy farming inputs.

(FGD, Male, 24 years old)

These sustainability challenges reflect both systemic issues in the broader economic environment and specific constraints faced by young entrepreneurs. Limited access to technical assistance, mentorship, and growth capital, combined with challenging market conditions, create an environment where business survival, let alone success, was extremely difficult.

5. Discussion

This study aimed to explore sustainable livelihoods as a strategy to reduce vulnerability among young adults living with HIV in East Seme Location, Seme sub-county, using Pierre Boudier’s concept of social capital. Although young people living with HIV still face many challenges when it comes to establishing and sustaining livelihoods, our findings show that integrating and emphasizing different types of capital within livelihoods can enhance participation and sustainability. Furthermore, we show that although social, cultural, and economic capital are distinct, as Pierre Bourdieu emphasized, they are interconnected and work together to influence individual agency needed to establish and sustain community-based livelihood projects. In this section, we demonstrate how factors related to different dimensions of capital affected youth participation, leadership, financial resource shortages, stigma and discrimination, technological knowledge gaps, and the sustainability of livelihood initiatives.

While this study focused on the youth living with HIV, we found that within this homogeneity, there were glaring levels of social disparities that impacted how individuals were perceived and participated in the group activities. For example, male participants had greater flexibility in home and community spaces to engage in economic activities outside the home, a privilege that female participants lacked. Additionally, most male participants reported completing college, holding leadership positions, and not having children of their own, in contrast to women. Even though these sociodemographic differences are not unique to this group, they highlight inequalities and power dynamics inherent in social spaces and their effects on well-being [43,44]. In relation to other studies that have used Bourdieu’s concept of capital [29,40], these dimensions are critical to understanding that the capital required for livelihoods extends beyond monetary value. Instead, capital in this sense is depicted in everyday life as the attainment of education, the freedom to participate in income-generating activities, and the agency to participate in the social life of a community. Social class, therefore, pertains to the relationship that an individual has with factors of production, but also with social structures [39].

5.1. The Influence of Social and Economic Capital on Participation

In our study, feelings of exclusion emerged as a persistent barrier to livelihoods among young people living with HIV, resulting in a lack of participation. While the factors that led to these feelings of exclusion were varied, financial obligations attached to livelihoods were among the greatest for young people. Additionally, we found that financial obligations persisted within community livelihood initiatives due to pressure to gain membership and shares. These obligations hindered active involvement from the early stages of participation in social groups. Although the lack of involvement is not a new concern for livelihood projects, our study shows that elements of capital are often overlooked by implementing partners, donors, or organizations that support livelihoods. This pattern aligns with broader critiques of participatory development ideas, which often assume that everyone can participate meaningfully without first tackling deeper structural inequalities [45].

A lack of capital—social, cultural, and economic—we argue, perpetuates structural inequalities and prevents young people from meaningfully participating in livelihoods. This exclusion can affect how young people see themselves, making them feel lonely or isolated. It can also make it harder to build strong social connections and work together effectively. In HIV prevention, most livelihood projects are donor-driven, and participation is viewed from a capacity-building perspective, notably through project planning and outcomes [46,47]. While these approaches are certainly valuable, we believe they do not fully capture the aspects of personal agency and meaningful participation within social groups.

While most informal livelihoods initiatives depend on inclusive, community-participatory processes [38], our study also shows that the lack of beneficiary involvement hampers their sustainability. These findings support arguments that flexible membership and progressive contributions can enhance the value of livelihood programs [48,49]. For instance, in Ethiopia and Bangladesh, livelihood programs that enable individuals to contribute labor, skills, or goods instead of cash can support group cohesion and reduce exclusion [50,51]. To succeed, livelihood programs need to encourage and value non-financial contributions.

The financial resource limitations highlighted in this study mirror broader financial exclusion trends affecting young people and marginalized groups across sub-Saharan Africa. For instance, in many African countries, traditional banks often do not serve those with unstable incomes, limited assets, or no credit history, such as young people [50]. While informal savings groups might provide alternative financial access, they cannot substitute for access to larger capital needed to start or grow a business [52]. Additionally, the limitations of group savings in generating significant business capital highlight the importance of adopting more advanced and structured financial mechanisms within livelihood programs.

These results align with other studies highlighting financial capital as a major obstacle to starting new businesses [52,53]. They also expand on the discussion of strict loan criteria, including the need to maintain proven revenue over several months, as well as the requirement for security and guarantors. In many sub-Saharan countries, financial institutions often hesitate to lend to youth-led or youth-involved groups because of perceived risks associated with their limited income and sustainability [54]. The finding that many young PLHIV cannot meet traditional credit requirements highlights the need for developing economic capital. This could mean developing financial products specifically for young people, starting with small loans that do not require collateral and increasing the loan amount as they demonstrate their ability to repay, or using group support and trust to ensure repayment. Fortunately, new programs such as those in Rwanda and Uganda have demonstrated that combining small grants with loan guarantees and technical assistance can enable young people to access credit while building credit histories for future borrowing [52].

5.2. Cultural Capital, Leadership, and Livelihood Projects

Our study found that a lack of cultural capital significantly contributed to leadership issues in livelihood initiatives among young adults, mainly because there was overreliance on officials lacking adequate leadership skills. While these findings are concerning, evidence suggests that these practices are standard in resource-limited areas and often lead to leadership wrangles, conflicts, corruption, and the prioritization of individual interests, thereby weakening the group’s success [53,54].

Youth-led sustainable livelihoods in similar contexts suggest that structured leadership development interventions can significantly improve group functioning and sustainability [55]. Further, comprehensive leadership development in livelihoods, including conflict resolution, financial management, and strategic planning, achieves significantly better outcomes than programs that focus entirely on technical training [56]. While cultural capital can help address leadership challenges, social capital to build meaningful relationships with potential mentors remains essential. Unfortunately, young people living with HIV may lack sufficient social support because of stigma and discrimination. Overcoming these challenges may require programs to build adequate social capital.

5.3. Social Capital, Stigma, and Discrimination in Livelihoods

The continuous impact of HIV-related stigma on livelihood opportunities represents one of the most challenging barriers identified in this study. Unlike challenges that can be solved by better planning or more resources, stigma is a complex social issue among young adults living with HIV. Stigma influences how people relate to one another and how institutions respond, affecting many aspects of life [57]. Although HIV-related stigma and discrimination have been shown to harm individuals’ relationships with society [58], our findings indicate that the impact on livelihoods is broader, affecting access to essential resources such as financial support and community-based social support, which are vital for sustaining any activity. Previous studies have highlighted that while specialized services are essential for addressing the specific needs of people living with HIV (PLHIV), but being seen using these services can lead to stigma that may outweigh the benefits [59,60]. As a result, researchers are now recommending more integrated care models that offer support for PLHIV without separating them from general programs to provide help without causing stigma [61].

This study highlights that HIV-related stigma and discrimination can erode social and economic resources, thereby continuing to reinforce inequalities. These findings align with results from other studies, which have reported that stigma and discrimination associated with HIV and AIDS are hindering access to resources for people living with HIV [62]. Additionally, although evidence from successful stigma-reduction efforts shows that community-wide interventions are usually crucial for creating supportive environments for livelihood programs [63], our findings also support the idea that involving community leaders, religious groups, and influential local figures can decrease stigma and enhance social support and behaviors [62]. Therefore, sustainable livelihoods are most effective when they are embraced by the community and integrated into a variety of initiatives. Rather than being standalone or vertical programs, they should be woven into government employment schemes, civil society efforts, and private sector programs, encouraging a sense of ownership and collective success.

5.4. The Influence of Cultural, Social, and Economic Capital on Knowledge, Information, and Livelihoods

Our study found that, despite greater access to smartphones, information about livelihoods still primarily depended on traditional methods like paper copies, especially within government ministries. Additionally, we found that behaviors related to phone-based information are quickly evolving, with young people’s attention decreasing and the majority favoring short, multimedia messages, including videos. Long, dense information is considered boring and receives very little attention. Additionally, while most participants were educated and held college diplomas, we found that many had little economic knowledge, especially on technology and the market. These findings are similar to those from other studies that have focused on knowledge, information, and livelihood. For example, most PLHIV groups in sub-Saharan Africa have been reported to possess inadequate access to knowledge of the existing high-value livelihoods [64]. Instead, these groups have relied on traditional sources of knowledge, which hampers the maximization of their returns [65]. This is despite the fact that livelihoods based on traditional methods often miss out on modern technology, resulting in lagging production, low yields, and poor value addition [66,67]. Moreover, the participants’ preference for visual and interactive content signals a change in learning behavior, presenting both challenges and opportunities for livelihood education. While knowledge and information are essential for improving livelihoods [66,67], delivery mechanisms must align with target population preferences and capabilities. Thus, these new social interaction methods not only reveal the underuse of available learning resources but also recognize multimedia as an alternative means for more effective knowledge transfer, especially when social and cultural capital are limited.

5.5. Dimensions of Capital and the Sustainability of Livelihood Projects

This study revealed that most livelihood initiatives were short-lived and lacked continuity. These challenges, however, reflected different dimensions of capital—social, cultural, and economic capital—and the community constraints that affected livelihoods among young adults living with HIV in Kisumu, Kenya. While young people were willing to engage in livelihood activities, finances, leadership, trust, and knowledge posed potential barriers and threatened sustainability efforts. Although Chambers and Conway argue that livelihoods are socially sustainable when they can cope with and recover from stress and shocks, and provide for future generations [68], this study reveals that most young people do not have adequate resources to achieve this equilibrium. In our study, the mix of economic issues, leadership concerns, knowledge gaps, and participation challenges made it really challenging for community livelihood initiatives to thrive.

Consistent with prior research in the region, market-related challenges such as limited local demand, poor transportation infrastructure, and competition from more established or imported goods further inhibit business sustainability [62,69]. Young entrepreneurs often lack the market knowledge, business networks, and capital necessary to compete effectively in these challenging environments. This study shows that many youth-run businesses manage to survive but do not grow. They earn just enough to get by, without making savings or helping the owners improve their lives in the long term [70,71].

This pattern has also been observed in other parts of Sub-Saharan Africa, where evidence suggests that youth entrepreneurship programs are only effective when they tackle multiple challenges simultaneously [72]. Further, these studies show that isolated interventions such as microfinance or short-term training rarely lead to sustainable outcomes on their own. Instead, integrated models that combine financial support, technical training, mentorship, and market access usually lead to longer-lasting business income growth [72]. Young people require ongoing support tailored to their local needs to effectively grow their businesses. Without this kind of help, they may stay stuck, lose motivation, and eventually close their businesses. Together, these factors highlight the importance of integrating the three dimensions of capital in livelihood interventions, particularly for young adults.

6. Limitations of the Study

The qualitative and cross-sectional design of this study, along with its limited sample, constrained its generalizability to a larger population. Additionally, since these groups consisted only of young persons living with HIV and participating in the HIV programs, the vulnerability of other youths outside this group and children may not be adequately addressed. Lastly, our analysis did not consider heterogeneity within the participant groups, further limiting the generalizability of our findings.

7. Conclusions

Livelihood projects continue to be vital for health and well-being. In the management of HIV, livelihood initiatives have supported individuals in overcoming structural challenges. Despite this significant contribution, numerous barriers remain, particularly among young people living with HIV. Pier Bourdieu’s conceptualization of capital provides an opportunity to develop innovative strategies to address these barriers. Augmenting social capital among vulnerable populations, for example, can serve as an effective initial step in fostering agency and resilience. Furthermore, building financial capital is an integral component for building cultural capital, acquiring knowledge, and gaining social status among peers. Sustainable livelihoods, particularly those aimed at vulnerable groups, must incorporate and evaluate different types of capital.