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Population-Based Study of Food Insecurity and HIV Transmission Risk Behaviors and Symptoms of Sexually Transmitted Infections Among Linked Couples in Nepal

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Abstract

Food insecurity has recently emerged as an important risk factor for HIV acquisition among women worldwide. No previous studies have used linked data that would permit investigation of the extent to which food insecurity may have differential associations with HIV transmission risk behaviors or symptoms of sexually transmitted infections (STIs) among men and women in the same households. We used nationally representative data on linked couples from the Nepal 2011 Demographic and Health Survey. The primary explanatory variable of interest was food insecurity, measured with a modified version of the Household Food Insecurity Access Scale. In multivariable logistic regression models, women in food insecure households were less likely to report recent condom use and more likely to report symptoms consistent with STIs. These patterns were absent among men. Interventions targeting food insecurity may have beneficial implications for both HIV prevention and gender equity in Nepal.

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Acknowledgments

The authors received no specific financial support for this study. ACT acknowledges salary support from U.S. National Institutes of Health (NIH) K23MH096620 and the Robert Wood Johnson Health and Society Scholars Program. SDW acknowledges salary support from the Hellman Family Foundation and the Burke Family Foundation. Preliminary findings were presented at the Center for AIDS Research Joint Symposium on HIV Research in Women, Providence, RI, September 19, 2012.

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Authors and Affiliations

  1. Chester M. Pierce, MD Division of Global Psychiatry and Center for Global Health, Massachusetts General Hospital, Room 1529-E3, 100 Cambridge Street, 15th floor, Boston, MA, 02114, USA

    Alexander C. Tsai

  2. Harvard Medical School, Boston, MA, USA

    Alexander C. Tsai

  3. Mbarara University of Science and Technology, Mbarara, Uganda

    Alexander C. Tsai

  4. Division of HIV/AIDS, San Francisco General Hospital, University of California at San Francisco, San Francisco, CA, USA

    Sheri D. Weiser

Authors
  1. Alexander C. Tsai
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  2. Sheri D. Weiser
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Correspondence to Alexander C. Tsai.

Appendix

Appendix

See Tables 5, 6 and 7.

Table 5 Individual components of the modified HFIAS (N = 2,322)
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Table 6 Bivariate correlates of HIV risk factors and transmission risk behaviors among partnered women in the 2011 Nepal Demographic and Health Survey (N = 2,322)
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Table 7 Bivariate correlates of HIV risk factors and transmission risk behaviors among partnered men in the 2011 Nepal Demographic and Health Survey (N = 2,322)
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Tsai, A.C., Weiser, S.D. Population-Based Study of Food Insecurity and HIV Transmission Risk Behaviors and Symptoms of Sexually Transmitted Infections Among Linked Couples in Nepal. AIDS Behav 18, 2187–2197 (2014). https://doi.org/10.1007/s10461-014-0794-z

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