Forty-nine million individuals are food insecure in the
United States, where food insecurity and HIV/AIDS are prevalent among the urban
poor. Food insecurity is associated with risky sexual behaviours among people
living with HIV/AIDS (PLHIV). No qualitative studies, however, have
investigated the mechanisms underlying this relationship either in a
resource-rich setting or among populations that include men who have sex with
men (MSM).
Semi-structured in-depth interviews were conducted with 34
low-income PLHIV receiving food assistance in the San Francisco Bay Area. The
interviews explored experiences with food insecurity and perceived associations
with sexual risk behaviours. Interviews were conducted in English,
audio-recorded and transcribed verbatim. Transcripts were coded and analyzed
according to content analysis methods using an inductive-deductive approach.
Food insecurity was reported to be a strong contributor to
risky sexual practices among MSM and female participants. Individuals described
engaging in transactional sex for food or money to buy food, often during times
of destitution. Participants also explained how food insecurity could lead to
condomless sex despite knowledge of and desire to use safe sexual practices,
largely because the need to obtain food in the short term was prioritized over
the desire to use barrier protection.
Our data extend previous research by demonstrating that food
insecurity contributes to transactional and unprotected sex among urban poor
individuals in a resource-rich setting, including among MSM. These findings
underscore the importance of public health and social intervention efforts
focused on structural inequalities.
Full article at: http://goo.gl/ssxcTA
By: Whittle HJ1, Palar K2, Napoles T2, Hufstedler LL2, Ching I3, Hecht FM2, Frongillo EA4, Weiser SD3,2,5.
1Global Health Sciences, University of California, San
Francisco (UCSF), San Francisco, CA, USA; harrywhittle@gmail.com.
2Division of HIV/AIDS, ID and Global Medicine,
Department of Medicine, University of California, San Francisco (UCSF), San
Francisco, CA, USA.
3Global Health Sciences, University of California, San
Francisco (UCSF), San Francisco, CA, USA.
4Department of Health Promotion, Education, and
Behavior, University of South Carolina, Columbia, SC, USA.
5Center for AIDS Prevention Studies, University of
California, San Francisco (UCSF), San Francisco, CA, USA
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