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Food Insufficiency, Substance Use, and Sexual Risks for HIV/AIDS in Informal Drinking Establishments, Cape Town, South Africa

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Abstract

HIV/AIDS is concentrated in impoverished communities. Two critical aspects of poverty are food insufficiency and substance abuse, and both are associated with sexual risks for HIV/AIDS in southern Africa. The current study is the first to examine both hunger and substance use in relation to sexual risks for HIV infection in South African alcohol serving establishments. Anonymous venue-based intercept surveys were completed by men (n = 388) and women (n = 407) patrons of six informal drinking places (e.g., shebeens) in Cape Town, South Africa. Food insufficiency and its more extreme form hunger were common in the sample, with 24 % of men and 53 % of women experiencing hunger in the previous 4 months. Multiple regression analyses showed that quantity of alcohol use was related to higher rates of unprotected sex for men and women. Trading sex to meet survival needs was related to food insufficiency and methamphetamine use among men but not women. Food insufficiency and substance use may both contribute to HIV risks in South African shebeens. However, the influence of hunger and substance use on sexual risks varies for men and women. Interventions to reduce HIV transmission risks may be bolstered by reducing both food insufficiency and substance use.

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Acknowledgments

This project was supported by the National Institute of Alcohol Abuse and Alcoholism grant R01 AA018074.

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Authors and Affiliations

  1. Department of Psychology, University of Connecticut, Storrs, CT, USA

    Seth C. Kalichman

  2. Duke University, Durham, NC, USA

    Melissa Watt & Kathleen Sikkema

  3. Stellenbosch University, Cape Town, South Africa

    Donald Skinner & Desiree Pieterse

Authors
  1. Seth C. Kalichman
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  2. Melissa Watt
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  3. Kathleen Sikkema
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  4. Donald Skinner
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  5. Desiree Pieterse
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Correspondence to Seth C. Kalichman.

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Kalichman, S.C., Watt, M., Sikkema, K. et al. Food Insufficiency, Substance Use, and Sexual Risks for HIV/AIDS in Informal Drinking Establishments, Cape Town, South Africa. J Urban Health 89, 939–951 (2012). https://doi.org/10.1007/s11524-012-9686-6

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  • DOI: https://doi.org/10.1007/s11524-012-9686-6

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