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Food Insecurity and Risky Sexual Behaviors Among Homeless and Marginally Housed HIV-Infected Individuals in San Francisco

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Abstract

Food insecurity is common among HIV-infected populations in resource-rich and resource-poor countries. We hypothesized that food insecurity would be associated with risky sexual behaviors. We examined this hypothesis among all sexually active participants (n = 154) in the Research on Access to Care in the Homeless (REACH) cohort in San Francisco. The outcomes were unprotected vaginal or anal sex and multiple sexual partners during the prior 90 days. Associations were examined using repeated measures multivariable logistic regression analyses. Food insecurity was independently associated with unprotected sexual activity (AOR = 2.01 for each five point increase in HFIAS scale, 95 % CI 1.31–3.10) and multiple sexual partners (AOR = 1.54 for each five-point increase in HFIAS scale, 95 % CI 1.05–2.29). Food insecurity is a risk factor for unprotected sexual activity and multiple sexual partners among homeless and marginally housed HIV-infected individuals in San Francisco. Measures to alleviate food insecurity may play a role in decreasing secondary HIV transmission.

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Acknowledgments

The authors wish to thank Brenda Goldhamer, Richard Clark, Matthew Reynolds, Joyce Powell, Becky Packard, John Weeks, and the REACH participants who shared the experiences that made this study possible. This publication was made possible by Grant Number UL1 RR024131 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or the NIH. Information on the NCRR is available at http://www.ncrr.nih.gov. This publication was supported by NIH/NIMH RO-1 54907, CHRP ID08-SF-054; UCSF Academic Senate; Hurlbut-Johnson funds from AIDS Research Institute award, UCSF, # 557858-8-148. Dr. Weiser received support from NIMH K23 MH079713-01 and the Hellman Family Foundation. Dr. Bangsberg received support from K-24 MH 87227.

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Authors and Affiliations

  1. Division of Infectious Diseases, Hennepin County Medical Center, 701 Park Avenue, O1, Minneapolis, MN, 55415, USA

    Nicholas S. Vogenthaler

  2. Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA

    Margot B. Kushel

  3. Department of Anthropology, Emory University, Atlanta, GA, USA

    Craig Hadley

  4. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Ed A. Frongillo Jr.

  5. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Elise D. Riley

  6. Massachusetts General Hospital, Harvard Medical School, Harvard Initiative for Global Health, Boston, MA, USA

    David R. Bangsberg

  7. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA

    Sheri D. Weiser

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  1. Nicholas S. Vogenthaler
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  2. Margot B. Kushel
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  3. Craig Hadley
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  4. Ed A. Frongillo Jr.
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  5. Elise D. Riley
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  6. David R. Bangsberg
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  7. Sheri D. Weiser
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Correspondence to Nicholas S. Vogenthaler.

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Vogenthaler, N.S., Kushel, M.B., Hadley, C. et al. Food Insecurity and Risky Sexual Behaviors Among Homeless and Marginally Housed HIV-Infected Individuals in San Francisco. AIDS Behav 17, 1688–1693 (2013). https://doi.org/10.1007/s10461-012-0355-2

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