Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017)
Objective To assess the potential bidirectional relationship between food insecurity and HIV infection in sub-Saharan Africa.Design Nationally representative HIV impact assessment household-based surveys.Setting Zambia, Eswatini, Lesotho, Uganda and Tanzania and Namibia.Participants 112 955 survey p...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e058704.full |
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| author | Danielle Barradas Nicholus Mutenda Hetal Patel Avi J Hakim Lloyd Mulenga Sally Findley Andrea Low George Rutherford Sarah Ayton Elizabeth Gummerson Amee Schwitters Rogerio Bonifacio Mekleet Teferi James Juma Claudia Ahpoe Choice Ginindza Samuel Biraro Karam Sachathep Ahmed Saadani Hassani Willford Kirungi Keisha Jackson Leah Goeke Neena Philips Jennifer Ward Steven Hong |
| author_facet | Danielle Barradas Nicholus Mutenda Hetal Patel Avi J Hakim Lloyd Mulenga Sally Findley Andrea Low George Rutherford Sarah Ayton Elizabeth Gummerson Amee Schwitters Rogerio Bonifacio Mekleet Teferi James Juma Claudia Ahpoe Choice Ginindza Samuel Biraro Karam Sachathep Ahmed Saadani Hassani Willford Kirungi Keisha Jackson Leah Goeke Neena Philips Jennifer Ward Steven Hong |
| author_sort | Danielle Barradas |
| collection | DOAJ |
| description | Objective To assess the potential bidirectional relationship between food insecurity and HIV infection in sub-Saharan Africa.Design Nationally representative HIV impact assessment household-based surveys.Setting Zambia, Eswatini, Lesotho, Uganda and Tanzania and Namibia.Participants 112 955 survey participants aged 15–59 years with HIV and recency test results.Measures Recent HIV infection (within 6 months) classified using the HIV-1 limited antigen avidity assay, in participants with an unsuppressed viral load (>1000 copies/mL) and no detectable antiretrovirals; severe food insecurity (SFI) defined as having no food in the house ≥three times in the past month.Results Overall, 10.3% of participants lived in households reporting SFI. SFI was most common in urban, woman-headed households, and in people with chronic HIV infection. Among women, SFI was associated with a twofold increase in risk of recent HIV infection (adjusted relative risk (aRR) 2.08, 95% CI 1.09 to 3.97). SFI was also associated with transactional sex (aRR 1.28, 95% CI 1.17 to 1.41), a history of forced sex (aRR 1.36, 95% CI 1.11 to 1.66) and condom-less sex with a partner of unknown or positive HIV status (aRR 1.08, 95% CI 1.02 to 1.14) in all women, and intergenerational sex (partner ≥10 years older) in women aged 15–24 years (aRR 1.23, 95% CI 1.03 to 1.46). Recent receipt of food support was protective against HIV acquisition (aRR 0.36, 95% CI 0.14 to 0.88).Conclusion SFI increased risk for HIV acquisition in women by twofold. Heightened food insecurity during climactic extremes could imperil HIV epidemic control, and food support to women with SFI during these events could reduce HIV transmission. |
| format | Article |
| id | doaj-art-ce4f32f3fd054d9b88811cbb13016b23 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-ce4f32f3fd054d9b88811cbb13016b232025-01-30T21:25:14ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-058704Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017)Danielle Barradas0Nicholus Mutenda1Hetal Patel2Avi J Hakim3Lloyd Mulenga4Sally Findley5Andrea Low6George Rutherford7Sarah Ayton8Elizabeth Gummerson9Amee Schwitters10Rogerio Bonifacio11Mekleet Teferi12James Juma13Claudia Ahpoe14Choice Ginindza15Samuel Biraro16Karam Sachathep17Ahmed Saadani Hassani18Willford Kirungi19Keisha Jackson20Leah Goeke21Neena Philips22Jennifer Ward23Steven Hong24Center for Global Health, Centers for Disease Control and Prevention, Lusaka, ZambiaDirectorate for Special Programs, Namibia Ministry of Health and Social Services, Windhoek, NamibiaCenter for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USACenter for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USAZambia Ministry of Health, Lusaka, ZambiaPopulation and Family Health, Mailman School of Public Health, New York, NY, USAICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USAInstitute for Global Health Sciences, University of California San Francisco, San Francisco, California, USAICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USAICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USAStrategic Information, Division of Global HIV and Tuberculosis, Ctr Dis Control, Maseru, LesothoGeospatial Analysis Unit, World Food Programme, Rome, ItalyICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USAThe Ministry of Health, Community Development, Gender, Elderly and Children, National AIDS Control Program, Dar es Salaam, United Republic of TanzaniaNeeds Assessment and Analysis, World Food Programme, Rome, ItalyCentral Statistical office, Mbabane, SwazilandICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USAICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USACenter for Global Health, Centers for Disease Control and Prevention, Lusaka, ZambiaAIDS Control Programme, Ministry of Health, Kampala, UgandaCenter for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USACenters for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania1 ICAP, Columbia University, New York, New York, USACenters for Disease Control and Prevention, Kampala, UgandaCenters for Disease Control and Prevention, Windhoek, NamibiaObjective To assess the potential bidirectional relationship between food insecurity and HIV infection in sub-Saharan Africa.Design Nationally representative HIV impact assessment household-based surveys.Setting Zambia, Eswatini, Lesotho, Uganda and Tanzania and Namibia.Participants 112 955 survey participants aged 15–59 years with HIV and recency test results.Measures Recent HIV infection (within 6 months) classified using the HIV-1 limited antigen avidity assay, in participants with an unsuppressed viral load (>1000 copies/mL) and no detectable antiretrovirals; severe food insecurity (SFI) defined as having no food in the house ≥three times in the past month.Results Overall, 10.3% of participants lived in households reporting SFI. SFI was most common in urban, woman-headed households, and in people with chronic HIV infection. Among women, SFI was associated with a twofold increase in risk of recent HIV infection (adjusted relative risk (aRR) 2.08, 95% CI 1.09 to 3.97). SFI was also associated with transactional sex (aRR 1.28, 95% CI 1.17 to 1.41), a history of forced sex (aRR 1.36, 95% CI 1.11 to 1.66) and condom-less sex with a partner of unknown or positive HIV status (aRR 1.08, 95% CI 1.02 to 1.14) in all women, and intergenerational sex (partner ≥10 years older) in women aged 15–24 years (aRR 1.23, 95% CI 1.03 to 1.46). Recent receipt of food support was protective against HIV acquisition (aRR 0.36, 95% CI 0.14 to 0.88).Conclusion SFI increased risk for HIV acquisition in women by twofold. Heightened food insecurity during climactic extremes could imperil HIV epidemic control, and food support to women with SFI during these events could reduce HIV transmission.https://bmjopen.bmj.com/content/12/7/e058704.full |
| spellingShingle | Danielle Barradas Nicholus Mutenda Hetal Patel Avi J Hakim Lloyd Mulenga Sally Findley Andrea Low George Rutherford Sarah Ayton Elizabeth Gummerson Amee Schwitters Rogerio Bonifacio Mekleet Teferi James Juma Claudia Ahpoe Choice Ginindza Samuel Biraro Karam Sachathep Ahmed Saadani Hassani Willford Kirungi Keisha Jackson Leah Goeke Neena Philips Jennifer Ward Steven Hong Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017) BMJ Open |
| title | Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017) |
| title_full | Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017) |
| title_fullStr | Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017) |
| title_full_unstemmed | Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017) |
| title_short | Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016–2017) |
| title_sort | food insecurity and the risk of hiv acquisition findings from population based surveys in six sub saharan african countries 2016 2017 |
| url | https://bmjopen.bmj.com/content/12/7/e058704.full |
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