Food insecurity, sexual risk behavior, and adherence to antiretroviral therapy among women living with HIV: A systematic review.
Elisabeth Chop, Avani Duggaraju, Angela Malley and 6 others
PMID 28586273WHAT IT FOUND
For women living with HIV, hunger was tied to sex for food, less control over condom use, and trouble starting or continuing ART.
Ask about food access before treating missed doses as simple nonadherence.
Key findings
01Food insecurity directly contributed to women living with HIV engaging in sex for food or resources, including transactional sex and sex work.
02Food insecurity was linked to less control in sexual relationships and difficulty negotiating condom use, including threats of losing food or violence.
03Hunger and lack of food were reported as barriers to initiating, continuing, and taking ART consistently.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only six studies met inclusion criteria, and five were qualitative, so the themes cannot establish whether an intervention works. The included studies came from only six countries, four in sub-Saharan Africa and two in North America, so results may not apply elsewhere. Some studies relied on self-reported sexual risk behavior and food security, which can be affected by social desirability or recall bias. The review broadened inclusion to any study presenting at least some data separately for women, making it hard to separate results by gender. Loss to follow-up was not reported for the prospective cohort study. The review did not examine other possible effects of food insecurity, such as maternal and infant health, stress, depression, or violence against women. Lack of access to clean water was not included in the definition of food insecurity.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read this review as evidence that food assistance or clinic advice improves ART adherence or reduces sexual risk. It describes associations and lived experiences from six mostly qualitative studies, not tested interventions.