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Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland

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 behav...

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Autores principales: Weiser, Sheri D, Leiter, Karen, Bangsberg, David R, Butler, Lisa M, Percy-de Korte, Fiona, Hlanze, Zakhe, Phaladze, Nthabiseng, Iacopino, Vincent, Heisler, Michele
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2039764/
https://www.ncbi.nlm.nih.gov/pubmed/17958460
http://dx.doi.org/10.1371/journal.pmed.0040260
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author Weiser, Sheri D
Leiter, Karen
Bangsberg, David R
Butler, Lisa M
Percy-de Korte, Fiona
Hlanze, Zakhe
Phaladze, Nthabiseng
Iacopino, Vincent
Heisler, Michele
author_facet Weiser, Sheri D
Leiter, Karen
Bangsberg, David R
Butler, Lisa M
Percy-de Korte, Fiona
Hlanze, Zakhe
Phaladze, Nthabiseng
Iacopino, Vincent
Heisler, Michele
author_sort Weiser, Sheri D
collection PubMed
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.
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spelling pubmed-20397642007-10-27 Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland Weiser, Sheri D Leiter, Karen Bangsberg, David R Butler, Lisa M Percy-de Korte, Fiona Hlanze, Zakhe Phaladze, Nthabiseng Iacopino, Vincent Heisler, Michele PLoS Med Research Article 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. Public Library of Science 2007-10 2007-10-23 /pmc/articles/PMC2039764/ /pubmed/17958460 http://dx.doi.org/10.1371/journal.pmed.0040260 Text en : © 2007 Weiser et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Weiser, Sheri D
Leiter, Karen
Bangsberg, David R
Butler, Lisa M
Percy-de Korte, Fiona
Hlanze, Zakhe
Phaladze, Nthabiseng
Iacopino, Vincent
Heisler, Michele
Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
title Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
title_full Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
title_fullStr Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
title_full_unstemmed Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
title_short Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland
title_sort food insufficiency is associated with high-risk sexual behavior among women in botswana and swaziland
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2039764/
https://www.ncbi.nlm.nih.gov/pubmed/17958460
http://dx.doi.org/10.1371/journal.pmed.0040260
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