Gender inequalities shape the experience of food insecurity among women living with HIV (WLHIV). We systematically reviewed the impact of food insecurity on sexual risk behaviors and antiretroviral therapy (ART) adherence among WLHIV. We included qualitative or quantitative peer-reviewed articles, extracted data in duplicate, and assessed rigor. Seven studies, from sub-Saharan Africa, North America, and Europe, met inclusion criteria. Food insecurity was associated with increased sexual risk through transactional sex and inability to negotiate safer sex. Hunger and food insecurity were barriers to ART initiation/adherence. Multidimensional programming and policies should simultaneously address poverty, gender inequality, food insecurity, and HIV.

Evidence supports the prevalence of a high-trauma class experiencing poorer mental health, and the detrimental impact of aggregated interpersonal and other traumas. We highlight the clinical importance of addressing polytraumatization classes, and comprehensively assessing the impact of all traumas.

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To capture the functional role of reckless and self-destructive behaviors (RSDBs) in posttraumatic stress disorder’s (PTSD) symptomatology, the E2 symptom was added in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. However, the lack of a validated, comprehensive, and clinically useful measure is a significant barrier to the assessment/treatment of PTSD’s E2 criterion. We developed and validated a measure assessing PTSD’s E2 criterion (Posttrauma Risky Behaviors Questionnaire [PRBQ]). We used two trauma-exposed samples who completed the PRBQ with additional RSDB and mental health measures: 417 participants recruited through Amazon’s Mechanical Turk and 530 college students. We followed recommended guidelines to develop the PRBQ; the PRBQ measured a unitary construct of RSDBs and demonstrated very good–excellent internal consistency (.94 and .82 in community and student samples, respectively). The PRBQ demonstrated convergent validity with measures of RSDBs (significant r/rs/rpb range = .10–.68) and mental health (significant r/rs/rpb range = .29–.65), and construct validity wherein severity and clinically significant levels of PTSD’s E2 criterion were associated with higher PRBQ scores. The PRBQ had incremental validity in predicting PTSD’s E2 criterion above and beyond an established measure of RSDBs (Risky Behaviors Questionnaire) in the community sample. Our results provide initial support for the utility, reliability, and validity (content, convergent, construct, and incremental) of the PRBQ in uniquely assessing PTSD’s E2 criterion (posttrauma RSDBs). The PRBQ is a practical and valid alternative to using PTSD’s single-item E2 criterion or a time-consuming battery of different RSDB measurers in clinical practice.