Barcelona 2013
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| Abstract #367 - E-Posters English | ||||
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Session: 50.116: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Ms. Annette Grotheer - Tufts University School of Medicine, United States |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: Food insecurity has been shown to increase risky sexual behavior associated with HIV transmission. This relationship has been hypothesized to be due to an inability to assure food procurement leading to transactional sex to obtain resources. In this study we aimed to determine how food insecurity may relate with high risk sexual behavior in a population not identified as high risk in rural Kenya. We examine possible pathways and characterize the relationships between food insecurity, HIV transmission knowledge, and condom use. | ||||
| Method / Issue: A cross-sectional study was conducted in Taita-Taveta County, Kenya, using a standardized questionnaire assessing socio-demographic characteristics, food insecurity, HIV transmission knowledge and self-reported condom use. Food insecurity was assessed using the household food insecurity access scale (HFIAS) and HIV transmission knowledge was assessed using questions adapted from the Prevention and Access to Care and Treatment Program questionnaire. Participants were recruited from the voluntary counseling and testing clinic and the general hospital population of the local district hospital. Separate multivariate logistic regression models were conducted to determine predictors independently associated with severe food insecurity, low HIV transmission scores, and low condom use. All regression models were adjusted for potential confounders. | ||||
| Results / Comments: Of the 233 participants, mean age was 36 years, 53% were female, and 69% had obtained a secondary education or higher. Thirty-three percent were HIV positive, 48% HIV negative, and 19% unknown HIV status. Thirty-three percent had severe food insecurity, 47% had low HIV transmission knowledge, and 50% stated that they rarely or never used condoms. Independent predictors of severe food insecurity were household income (OR 0.90, 95%CI 0.83-0.94) for every Ksh 1,000, living in a household with a known HIV-infected individual (OR 3.46, 95%CI 1.26-9.50), and accepting money or gifts for sex (OR 9.50, 95%CI 1.86-48.5). Severe food insecurity (OR 2.04, 95%CI 1.02-4.17) was in turn an independent predictor of low HIV transmission knowledge and low HIV transmission knowledge (OR 1.83, 95%CI 1.01-3.31) was an independent predictor of low condom use. Other independent predictors of low condom use were, single marital status (OR 0.49, 95%CI 0.25-0.94) and having two or more sexual partners in the preceding year (OR 0.63, 95%CI 0.45-0.88). | ||||
| Discussion: These results suggest that the relationship between food insecurity and risky sexual behavior may be mediated through knowledge of HIV transmission in this rural setting. This finding differs from the association previously shown between food insecurity and high-risk behavior that was independent of knowledge of HIV transmission. Understanding the causal pathways leading to high risk behavior for HIV infection in different populations and settings is important in designing appropriate interventions to successfully prevent HIV transmission. Longitudinal data are needed to further explore these relationships. | ||||
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