Not having enough food is associated with a higher frequency of multiple high-risk sexual behaviours among women in Botswana and Swaziland, a study published in the October edition of PLoS Medicine has found. Women who reported food insecurity in the previous year had an 80 percent increase in their likelihood of transaction sex, a 70 percent increase in their risk of reporting unprotected sex with a non-primary partner, and a 50 percent increase in their likelihood of intergenerational sex.
All these are factors associated with an increased risk of HIV infection in previous research. The study’s investigators suggested that targeted food support could help reduce HIV transmission amongst women in sub-Saharan Africa.
Among women, a lack of food was associated with a 70 percent increase in the likelihood of inconsistent condom use with a non-primary partner in the previous year. Women who were heavy drinkers were almost seven times more likely to report inconsistent condom use . However, older age, a higher level of education, and a good knowledge of HIV prevention were all associated with a lower likelihood of reporting unprotected sex for all women.
Food insecurity was associated with an 84 percent increase in the likelihood of a woman engaging in transactional sex .Women who were heavy drinkers were over 15 times more likely to report transactional sex.
Intergenerational sex was also associated with food insecurity amongst women, with an almost 50 percent increase in the likelihood among food-insecure women .Yet again, heavy drinking significantly increased the risk of intergenerational sex for all women.
Women reporting food insecurity had a 70 percent increase in the risk of reporting a lack of control in sexual relationships, although a higher level of education reduced this risk overall for all women.
Food insecurity was associated with a doubling in the odds of a woman reporting forced sex. Heavy drinking increased the odds of forced sex further for all women.
The associations between food insecurity and sexual risk taking were much weaker for men. “Our population-based study found that food insecurity was associated with multiple risky sexual practices for women in Botswana and Swaziland,” write the investigators.
The investigators add, “Our findings suggest that interventions that use targeted food supplementation and food production strategies could help address some of the gender and economic disparities that drive unsafe sexual behaviors, and should be considered as a way to reduce HIV transmission behaviors in specific high-risk populations.”