Food insecurity, HIV status and prior testing at South African primary healthcare clinics

Abstract

HIV and food insecurity are two prominent causes of morbidity and mortality in sub-Saharan Africa. Food insecurity has been associated with risky sexual practices and poor access to healthcare services. We describe the association between household food insecurity and previous HIV testing and HIV status. We used logistic regression to analyse the association between food insecurity and prior HIV counselling and testing (HCT) and testing HIV positive. A total of 2742 adults who presented for HCT at three primary healthcare clinics in KwaZulu-Natal, South Africa, participated in the study. The prevalence of household food insecurity was 35%. The prevalence of food insecurity was highest in adults who had incomplete high schooling (43%), were unemployed (39%), and whose primary source of income was government grants (50%). Individuals who were food insecure had significantly higher odds of testing HIV positive (adjusted odds ratio 1.41, 95% CI 1.16–1.71), adjusted for demographic and socio-economic variables. There was no association between food insecurity and prior HCT. The findings of this study highlight the important role food insecurity may play in HIV risk. Interventions to turn food-insecure into food-secure households are needed to reduce their household members’ vulnerability to HIV acquisition. The absence of such interventions is likely to severely impact ambitious global targets of ending AIDS by 2030 through the 90-90-90 targets and test-and-treat-all initiatives.

Mental Health among African American and Latinx Men who have sex with men after the COVID-19 Lockdown in Los Angeles – Findings from the HOPE cohort

“…We found that the majority of participants experienced food insecurity during the lockdown time. Food insecurity among MSM has been shown to be associated with lower rates of HIV testing (Nyirenda et al, 2018 ; Takada et al, 2020 ; Weinhardt et al, 2017 ; Wiss et al, 2021 ), higher new HIV infection (Amon Exavery et al, 2020 ), and potential violence in the community (Adhikari et al, 2020 ). It is important to improve the access to food secure care programs.…”

<p>Relationship Between Food Insufficiency and HIV Infection Among Caregivers of Orphans and Vulnerable Children in Tanzania</p>

“…This finding is consistent with several others. [28][29][30] One of the possible mechanisms responsible for food insufficiency is that while concentrating on taking care of the OVC, the caregiver may not always have adequate time to participate in food production activities such as farming or income generating businesses. 31 Since lack of adequate food increases HIV risk behaviors, 32 the likelihood of HIV infection increases as well.…”