Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Oct;4(10):1589-97; discussion 1598.
doi: 10.1371/journal.pmed.0040260.

Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland

Sheri D Weiser  1 , Karen Leiter, David R Bangsberg, Lisa M Butler, Fiona Percy-de Korte, Zakhe Hlanze, Nthabiseng Phaladze, Vincent Iacopino, Michele Heisler
Affiliations

Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland

Sheri D Weiser et al. PLoS Med. 2007 Oct.

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Comment in

References

    1. Gillespie S, Kadiyala S. HIV/AIDS and Food and Nutrition Security: From Evidence to Action. Washington (D. C.): International Food Policy Reseach Institute; 2005. 149
    1. The state of food insecurity in the world 2003: monitoring progress towards the world food summit and millenium development goals. Rome (Italy): Food and Agriculture Organization. United Nations; 2003. Available at: http://www.fao.org/docrep/006/j0083e/j0083e00.html. Accessed 25 October 2005.
    1. Marston B, De Cock KM. Multivitamins, nutrition, and antiretroviral therapy for HIV disease in Africa. N Engl J Med. 2004;351:78–80. - PubMed
    1. de Waal A, Whiteside A. New variant famine: AIDS and food crisis in southern Africa. Lancet. 2003;362:1234–1237. - PubMed
    1. The impact of HIV/AIDS on the agricultural sector and rural livelihoods in Uganda. Uganda: The National Agricultural Advisory Services; 2003. Available at: ftp://ftp.fao.org/sd/SDW/SDWW/uganda_hiv_aids_survey_sept2003.pdf. Accessed 15 December 2005.

Publication types

MeSH terms