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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
arts and humanities
The social context of food insecurity among persons living with HIV/AIDS in rural Uganda
Social Science and Medicine, Volume 73, No. 12, Year 2011
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Description
HIV/AIDS and food insecurity are two of the leading causes of morbidity and mortality in sub-Saharan Africa, with each heightening the vulnerability to, and worsening the severity of, the other. Less research has focused on the social determinants of food insecurity in resource-limited settings, including social support and HIV-related stigma. In this study, we analyzed data from a cohort of 456 persons from the Uganda AIDS Rural Treatment Outcomes study, an ongoing prospective cohort of persons living with HIV/AIDS (PLWHA) initiating HIV antiretroviral therapy in Mbarara, Uganda. Quarterly data were collected by structured interviews. The primary outcome, food insecurity, was measured with the Household Food Insecurity Access Scale. Key covariates of interest included social support, internalized HIV-related stigma, HIV-related enacted stigma, and disclosure of HIV serostatus. Severe food insecurity was highly prevalent overall (38%) and more prevalent among women than among men. Social support, HIV disclosure, and internalized HIV-related stigma were associated with food insecurity; these associations persisted after adjusting for household wealth, employment status, and other previously identified correlates of food insecurity. The adverse effects of internalized stigma persisted in a lagged specification, and the beneficial effect of social support further persisted after the inclusion of fixed effects. International organizations have increasingly advocated for addressing food insecurity as part of HIV/AIDS programming to improve morbidity and mortality. This study provides quantitative evidence on social determinants of food insecurity among PLWHA in resource-limited settings and suggests points of intervention. These findings also indicate that structural interventions to improve social support and/or decrease HIV-related stigma may also improve the food security of PLWHA. © 2011 Elsevier Ltd.
Authors & Co-Authors
Tsai, Alexander C.
United States, Cambridge
Harvard University
Bangsberg, David R.
United States, Boston
Harvard Medical School
United States, Cambridge
Harvard Initiative for Global Health
United States, Boston
Massachusetts General Hospital
Uganda, Mbarara
Mbarara University of Science and Technology
United States, Cambridge
Massachusetts Institute of Technology
United States, Boston
Brigham and Women's Hospital
Emenyonu, Nneka I.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Senkungu, Jude Kimbowa
Uganda, Mbarara
Mbarara University of Science and Technology
Martin, Jeffrey N.
United States, San Francisco
University of California, San Francisco
Weiser, Sheri D.
United States, San Francisco
Ucsf Center for Aids Prevention Studies
Statistics
Citations: 178
Authors: 6
Affiliations: 10
Identifiers
Doi:
10.1016/j.socscimed.2011.09.026
ISSN:
02779536
e-ISSN:
18735347
Research Areas
Food Security
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda
Participants Gender
Male
Female