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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland
PLoS Medicine, Volume 4, No. 10, Year 2007
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Description
Background: Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. Methods and Findings: We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27-2.36), sex exchange (AOR 1.84, 95% CI 1.74-1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03-2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24-2.28). Associations between food insufficiency and risky sex were much attenuated among men. Conclusions: Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women. © 2007 Weiser et al.
Authors & Co-Authors
Weiser, Sheri D.
United States, Cambridge
Physicians for Human Rights
United States, San Francisco
University of California, San Francisco
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Leiter, Karen S.
United States, Cambridge
Physicians for Human Rights
Bangsberg, David R.
United States, San Francisco
University of California, San Francisco
Butler, Lisa M.
United States, San Francisco
University of California, San Francisco
Percy-de Korte, Fiona
United States, Cambridge
Physicians for Human Rights
Hlanze, Zakhe
Swaziland, Mbabane
Women and Law in Southern Africa Research Trust
Phaladze, Nthabiseng A.
Botswana, Gaborone
University of Botswana
Iacopino, Vincent
United States, Cambridge
Physicians for Human Rights
United States, Minneapolis
University of Minnesota Twin Cities
Heisler, Michele M.
United States, Cambridge
Physicians for Human Rights
United States, Ann Arbor
University of Michigan Medical School
United States, Ann Arbor
Va Ann Arbor Healthcare System
Statistics
Citations: 434
Authors: 9
Affiliations: 8
Identifiers
Doi:
10.1371/journal.pmed.0040260
ISSN:
15491277
e-ISSN:
15491676
Research Areas
Food Security
Infectious Diseases
Sexual And Reproductive Health
Substance Abuse
Study Design
Cross Sectional Study
Case-Control Study
Study Locations
Botswana
Eswatini
Participants Gender
Male
Female