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Waterman EA, McLain M, Zulfiqar H, Ahmar Qadeer T, Ciavoi SM. The Link Between Intimate Partner Violence and Food Insecurity: A Review of Quantitative and Qualitative Studies. TRAUMA, VIOLENCE & ABUSE 2024; 25:1511-1530. [PMID: 37485673 DOI: 10.1177/15248380231186152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Intimate partner violence (IPV) and food insecurity are global health issues that affect millions of people worldwide. Numerous studies show that IPV and food insecurity are linked; however, there is a lack of synthesis of this research. Using a systematic search and review, we examined the international quantitative and qualitative research published on the link between IPV and food insecurity. We searched for peer-reviewed, English-language articles with participants above the age of 16 in 4 large online databases. Fifty-six studies were included from around the world that discussed the link between food insecurity and IPV perpetration and/or victimization. We found evidence in both qualitative and quantitative studies for a meaningful connection between these two global health isues. We also reviewed the literature on moderators and mediators (e.g., mental health). Our findings indicate the importance of implementing IPV prevention strategies which also address household food insecurity, and the potential for food insecurity resources to provide IPV resources. Future research should focus more frequently on IPV perpetration as opposed to victimization, and further examine the moderating and mediating mechanisms that inform the link between IPV and food insecurity.
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Rosen F, Settel L, Irvine F, Koselka EPD, Miller JD, Young SL. Associations between food insecurity and child and parental physical, nutritional, psychosocial and economic well-being globally during the first 1000 days: A scoping review. MATERNAL & CHILD NUTRITION 2024; 20:e13574. [PMID: 37828823 PMCID: PMC10750018 DOI: 10.1111/mcn.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
Food insecurity affects billions of individuals annually and contributes to myriad poor health outcomes. Experiences of food insecurity may be particularly harmful during the first 1000 days, but literature on the topic has not been synthesized. We therefore aimed to characterize all available studies examining associations between food insecurity and nutritional, psychosocial, physical and economic well-being among parents and children during this period. We implemented a standardized search strategy across 11 databases. Four researchers screened 10,257 articles, 120 of which met the inclusion criteria. Most studies were conducted in Sub-Saharan Africa (43.3%), followed by North America (20.8%). Studies were primarily quantitative (95.8%), cross-sectional (70.0%) and focused on women (pregnant or post-partum, 48.3%) or women and children (15.8%). Physical health outcomes were the most investigated (n = 87 studies), followed by nutritional (n = 69), psychosocial (n = 35) and economic well-being (n = 2). The most studied associations were between food insecurity and stunting (n = 15), maternal depression (n = 12), child dietary diversity (n = 7) and maternal body mass index (n = 6). The strength of evidence for the observed associations varied across populations as well as within and between examined outcomes. We recommend that future studies recruit more diverse study populations, consider temporality of relationships, use instruments that facilitate cross-site comparisons, measure individual-level food insecurity and outcomes most likely to be impacted by food insecurity, evaluate contextual factors that may modify the effects of food insecurity and employ analytic techniques that permit assessment of causal pathways.
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Affiliation(s)
- Francesca Rosen
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | - Lily Settel
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
| | - Faith Irvine
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Joshua D. Miller
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sera L. Young
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Institute for Policy ResearchNorthwestern UniversityEvanstonIllinoisUSA
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Meyer SR, Mosha NR, Hatcher AM, Hashim R, Ayieko P, Kapiga S, Mshana G, Stöckl H. Food Insecurity and Intimate Partner Violence in Mwanza, Tanzania: A Longitudinal Analysis. Am J Prev Med 2023; 65:932-939. [PMID: 37343708 DOI: 10.1016/j.amepre.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Food insecurity is a potential predictor of intimate partner violence. This study (1) describes the prevalence of food insecurity and various forms of intimate partner violence experience among women in Mwanza, Tanzania; and (2) assesses the effect of food insecurity and hunger on various forms of women's experience of intimate partner violence longitudinally. METHODS Women (aged 18-70 years) who reported being in a relationship in the past 12 months, who had participated in the control arms of two randomized controlled trials conducted as part of the MAISHA study were interviewed at four time points (N=1,004 at baseline in 2017). Analyses were conducted in 2022. Associations between food insecurity exposures and intimate partner violence outcomes were assessed, and univariate random effect logistic models were conducted to identify relevant sociodemographic variables (including age, education level, and SES) that were statistically significant. Multivariable random effects logistic models were conducted, including time as a fixed effect, to calculate odds ratios indicating associations between food insecurity exposures and intimate partner violence outcomes. RESULTS Prevalence of food insecurity was 47.7%, 55.6%, 47.2%, and 50.8% for each of the 4 waves, respectively, with significant difference in proportion of food insecurity between baseline and Wave 2. Multivariable random effects models indicated that food insecurity was associated with increased odds of exposure to all forms of intimate partner violence outcomes, and hunger was significantly associated with increased odds of experience of all intimate partner violence outcomes, apart from controlling behaviors. CONCLUSIONS Results from this longitudinal analysis of food insecurity and women's reports of intimate partner violence experience in a low- and middle-income country setting indicate that food insecurity is significantly associated with all forms of intimate partner violence, apart from controlling behaviors, among women in this sample in Mwanza, Tanzania. Policy and programmatic implications include the need for integrated intimate partner violence prevention programming to take into account household food needs.
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Affiliation(s)
- Sarah R Meyer
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine LMU Munich, München, Germany; Pettenkofer School of Public Health, Munich, Germany
| | - Neema R Mosha
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine LMU Munich, München, Germany; Pettenkofer School of Public Health, Munich, Germany; Mwanza Intervention Trials Unit, Mwanza, Tanzania
| | - Abigail M Hatcher
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Philip Ayieko
- Mwanza Intervention Trials Unit, Mwanza, Tanzania; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gerry Mshana
- Mwanza Intervention Trials Unit, Mwanza, Tanzania; National Institute for Medical Research, Mwanza, Tanzania
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine LMU Munich, München, Germany; Pettenkofer School of Public Health, Munich, Germany; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Idrisov B, Lunze K, Cheng DM, Blokhina E, Gnatienko N, Patts G, Bridden C, Rossi SL, Weiser SD, Krupitsky E, Samet JH. Food Insecurity and Transmission Risks Among People with HIV Who Use Substances. AIDS Behav 2023; 27:2376-2389. [PMID: 36670209 PMCID: PMC9859749 DOI: 10.1007/s10461-022-03965-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 01/22/2023]
Abstract
Food insecurity (FI) impacts people with HIV (PWH) and those who use substances (i.e. drugs and alcohol). We evaluated the longitudinal association between FI and HIV transmission risks (unprotected sexual contacts and shared needles/syringes). Among 351 PWH who use substances in Russia, 51.6% reported FI and 37.0% past month injection drug use. The mean number of unprotected sexual contacts in the past 90 days was 13.4 (SD 30.1); 9.7% reported sharing needles/syringes in the past month. We did not find a significant association between mild/moderate FI (adjusted IRR = 0.87, 95% CI 0.47, 1.61) or severe FI (aIRR = 0.84, 95% CI 0.46, 1.54; global p = 0.85) and unprotected sexual contacts. We observed a significant association between severe FI and sharing needles/syringes in the past month (adjusted OR = 3.27, 95% CI 1.45, 7.39; p = 0.004), but not between mild/moderate FI and sharing needles/syringes in the past month (aOR = 1.40,95% CI 0.58, 3.38; p = 0.45). These findings suggest that severe FI could be a potential target for interventions to lower HIV transmission.
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Affiliation(s)
- Bulat Idrisov
- Bashkir State Medical University, Ufa, Russia.
- Department of Health Systems and Population Health, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195-7660, USA.
| | - Karsten Lunze
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Debbie M Cheng
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Elena Blokhina
- Lab of Clinical Pharmacology of Addictions, Pavlov University, St. Petersburg, Russia
| | - Natalia Gnatienko
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, Boston, MA, USA
| | - Gregory Patts
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA
| | - Carly Bridden
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, Boston, MA, USA
| | - Sarah L Rossi
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, Boston, MA, USA
| | - Sheri D Weiser
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Evgeny Krupitsky
- Lab of Clinical Pharmacology of Addictions, Pavlov University, St. Petersburg, Russia
- V.M. Bekhterev National Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - Jeffrey H Samet
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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Koivu AM, Näsänen-Gilmore PK, Hunter PJ, Muthiani Y, Isojärvi J, Heimonen O, Bastola K, Csonka L, Ashorn P, Ashorn U. Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight. Am J Clin Nutr 2023; 117 Suppl 2:S148-S159. [PMID: 37331761 DOI: 10.1016/j.ajcnut.2022.11.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/11/2022] [Accepted: 11/08/2022] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Risk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW). OBJECTIVE This systematic search and review aims to provide a comparative evidence synthesis on the effect of eleven antenatal interventions targeted to address psychosocial risk factors on adverse birth outcomes. METHODS We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between March 2020 and May 2020. We included randomized controlled trials (RCTs) and reviews of RCTs of eleven antenatal interventions for pregnant females reporting LBW, preterm birth (PTB), small-for-gestational-age or stillbirth as outcomes. For interventions where randomization was either not feasible or unethical, we accepted non-randomized controlled studies. RESULTS Seven records contributed data to the quantitative estimates of the effect sizes and 23 contributed to narrative analysis. Psychosocial interventions for reducing smoking in pregnancy likely reduced the risk of LBW, and professionally provided psychosocial support for at-risk women possibly reduced the risk of PTB. Financial incentives or nicotine replacement therapy as smoking cessation aids, or virtually delivered psychosocial support did not appear to reduce the risk of adverse birth outcomes. The available evidence on these interventions was primarily from high-income countries. For other reviewed interventions (psychosocial interventions to reduce alcohol use, group based psychosocial support programs, intimate partner violence prevention interventions, antidepressant medication, and cash transfers) there was little evidence in any direction regarding the efficacy or the data was conflicting. CONCLUSIONS Professionally provided psychosocial support during pregnancy in general and specifically as a means to reduce smoking can potentially contribute to improved newborn health. The gaps in the investments for research and implementation of psychosocial interventions should be addressed to better meet the global targets in LBW reduction.
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Affiliation(s)
- Annariina M Koivu
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Pieta K Näsänen-Gilmore
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Institute for Health and Welfare, FI-00271, Helsinki, Finland
| | | | - Yvonne Muthiani
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jaana Isojärvi
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Otto Heimonen
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kalpana Bastola
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Leon Csonka
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Per Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Ulla Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Callands TA, Hylick K, Desrosiers A, Gilliam SM, Taylor EN, Hunter JJ, Hansen NB. The feasibility and acceptability of Project POWER: a mindfulness-infused, cognitive-behavioral group intervention to address mental and sexual health needs of young pregnant women in Liberia. BMC Pregnancy Childbirth 2023; 23:196. [PMID: 36941545 PMCID: PMC10026523 DOI: 10.1186/s12884-023-05435-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/08/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Following 14 years of civil war in Liberia, war exposure, gender-based violence, and extreme poverty have been identified as key challenges affecting the mental and sexual health of young pregnant women and the health of their unborn children. Despite ongoing efforts to rebuild the country's healthcare infrastructure, empirical and culturally tailored interventions to address the consequences of war are severely limited. To address these concerns, we developed Project POWER (Progressing Our Well-being, Emotions, and Relationships), a mindfulness-infused, cognitive-behavioral intervention for young adult pregnant women. This study sought to 1) assess the feasibility and acceptability of POWER and 2) determine the preliminary efficacy of POWER for improving mental and sexual health outcomes among Liberian war-exposed young adult pregnant women. METHODS Eighty-seven women aged 18-25 were recruited from three catchment areas in Monrovia, Liberia to participate in a two-condition, pre-post design quasi-experimental pilot trial. Participants were allocated to the intervention (POWER) or the control condition (a health education program) based on where they resided relative to the catchment areas. Each condition completed a ten-session program delivered over 5-weeks. Feasibility and acceptability of POWER were examined using program logs (e.g., the number of participants screened and enrolled, facilitator satisfaction, etc.) and data from an end-of-program exit interview. The preliminary efficacy of POWER on mental and sexual health outcomes was assessed using repeated measures ANOVA with time and condition as factors. RESULTS Analyses provided preliminary support for the feasibility and acceptability of POWER. Participants attended an average of 8.99 sessions out of 10 and practiced material outside the sessions at least 2.77 times per week. Women in both conditions showed significant reductions in the level of prenatal distress (baseline, M = 16.84, 3-month assessment, M = 12.24), severity of post-traumatic stress disorder (PTSD) symptoms (baseline, M = 11.97, 3-month assessment, M = 9.79),), and the number of transactional sexual behaviors (baseline, M = 1.37, 3-month assessment, M = .94) over time. Participants who received POWER showed significant reductions in the frequency of depressive symptoms (baseline, M = 5.09, 3-month assessment, M = 2.63) over women in the control condition. CONCLUSIONS Findings suggest that POWER may be a feasible and acceptable intervention to promote mental and sexual health for young adult pregnant women in Liberia. However, fully powered clinical trials are still needed to determine the efficacy and effectiveness of POWER before recommending its use on a larger scale in Liberia.
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Affiliation(s)
- Tamora A Callands
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Wright Hall, Room 321D, 100 Foster Road, Athens, GA, 30606, USA.
| | - Kandyce Hylick
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Wright Hall, Room 321D, 100 Foster Road, Athens, GA, 30606, USA
| | - Alethea Desrosiers
- Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Shantesica M Gilliam
- Department of Environmental and Health Science, Spelman College, Atlanta, GA, USA
| | - Erica N Taylor
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Wright Hall, Room 321D, 100 Foster Road, Athens, GA, 30606, USA
| | - Josalin J Hunter
- School of Social Work, College of Health and Human Sciences, University of North Carolina Wilmington, Wilmington, USA
| | - Nathan B Hansen
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Wright Hall, Room 321D, 100 Foster Road, Athens, GA, 30606, USA
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Bloom BE, Wagman JA, Dunkle K, Fielding-Miller R. Exploring intimate partner violence among pregnant Eswatini women seeking antenatal care: How agency and food security impact violence-related outcomes. Glob Public Health 2022; 17:3465-3475. [PMID: 33242387 PMCID: PMC10484090 DOI: 10.1080/17441692.2020.1849347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023]
Abstract
Women with agency (i.e. the ability to make choices and act on them) may experience reduced food insecurity (FI) and intimate partner violence (IPV). Reducing FI and IPV among women are global goals; however, research focused on agency among Eswatini women has been overlooked, though they experience high rates of FI and IPV. We analysed cross-sectional data from 406 Swazi women who sought care at one rural and one urban-public antenatal clinic in 2013-2014 to understand how FI and agency, our independent variables, are associated with IPV. We assessed the incidence rate ratio (IRR) of number of violent events (including emotional, physical and sexual IPV) in the previous 12 months using Poisson regressions. We found significant relationships between FI and IPV, where higher levels of FI were associated with IPV risk (weekly: IRR = 2.18, 95% CI = 1.82-2.61; Daily: IRR = 3.53, 95% CI = 2.89-4.32) and constrained agency increased women's risk of IPV (IRR = 1.44; 95% CI = 1.22-1.70). Our findings suggest that FI and agency independently impact women's experience(s) of IPV. Interventions focused on women simultaneously experiencing severe FI and constrained agency may have the highest impact; however, providing focused and moderate FI relief (e.g. reducing FI daily to monthly) could potentially reduce women's risk of experiencing violence.
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Affiliation(s)
- Brittnie E. Bloom
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
- Department of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego, CA, USA
| | - Jennifer A. Wagman
- Fielding School of Public Health, Department of Community Health Sciences, University of California, Los Angeles, CA, USA
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
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Postmus JL, Nikolova K, Lin HF, Johnson L. Women's Economic Abuse Experiences: Results from the UN Multi-Country Study on Men and Violence in Asia and the Pacific. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP13115-NP13142. [PMID: 33765852 DOI: 10.1177/08862605211003168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Economic abuse is a poorly understood form of intimate partner violence but may have far-reaching implications for the financial health of the survivor. Additionally, very little is known about whether depressive symptoms, education, employment, or attitudes about relations between men and women mediate or moderate the relationship between economic abuse and their financial circumstances. The purpose of this study was to answer these two research questions: (a) Is there a relationship between the experience of economic abuse and food insecurity (as a measure of poverty)? (b) Is the relationship between economic abuse and food insecurity impacted by women's education, women's and men's employment, women's attitudes towards gender relations, or women's depressive symptoms? We used quantitative data from the "UN Multi-Country Study on Men and Violence," analyzing data on 3,105 women aged 18-49 years who were interviewed. Initial logistic regressions were conducted followed by introducing moderators and mediators to the model using path analyses to test the relationship between economic abuse and food insecurity in the household. Significant predictors of food insecurity included several types of abuse and partners' employment, women's own employment, and education. The only type of IPV not associated with food insecurity was physical abuse. Experiences of economic abuse were associated with a 1.69 times greater likelihood of reporting food insecurity which was higher than experiences of psychological or sexual abuse. Additionally, women's experiences of economic abuse over their lifetime were significantly associated with an increase in depressive symptoms which in turn was associated with greater likelihood of experiencing food insecurity. Such relationships warrant attention to economic abuse and depressive symptoms as part of the interventions used when working with survivors. Additional research could also help further our understanding of how these variables interact together and how best to address its impact on survivors.
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Mukamana JI, Machakanja P, Zeeb H, Yaya S, Adjei NK. Investigating the associations between intimate partner violence and nutritional status of women in Zimbabwe. PLoS One 2022; 17:e0272038. [PMID: 35877657 PMCID: PMC9312962 DOI: 10.1371/journal.pone.0272038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women and poor nutritional status are growing health problems in low and middle-income countries (LMICs). Moreover, violence against women has been shown to be associated with poor nutrition. This study investigated the relationship between IPV and nutritional status (i.e., underweight, overweight, and obesity) among women of reproductive age (15-49 years) in Zimbabwe. METHODS Pooled data from the 2005/2006, 2010/2011, and 2015 Zimbabwe Demographic Health Surveys (ZDHS) on 13,008 married/cohabiting women were analysed. Multinomial logistic regression models were used to examine the associations between the various forms of IPV and the nutritional status of women. We further estimated the prevalence of BMI ≥ 25.0 kg/m2 (overweight and obesity) by intimate partner violence type. RESULTS The mean BMI of women was 24.3 kg/m2, more than one-fifth (24%) were overweight and about 12% were obese. Forty-three percent (43%) of women reported to have ever experienced at least one form of intimate partner violence. More than one-third (35%) of women who reported to have ever experienced at least one form of intimate partner violence had a BMI ≥ 25.0 kg/m2 (p< 0.01). Relative to normal weight, women who had ever experienced at least one form of IPV (i.e., physical, emotional, or sexual) were more likely to be obese (aOR = 2.59; 95% CI = 1.05-6.39). Women's exposure to any form of intimate partner violence was not significantly associated with the likelihood of being underweight or overweight relative to normal weight. CONCLUSIONS The study findings show that women of reproductive age in Zimbabwe are at high risk of both IPV and excess weight. Moreover, we found a positive relationship between exposure to at least one form IPV and obesity. Public health interventions that target the well-being, empowerment and development of women are needed to address the complex issue of IPV and adverse health outcomes, including obesity.
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Affiliation(s)
| | - Pamela Machakanja
- Institute of Peace, Leadership and Governance, Africa University, Mutare, Zimbabwe
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | - Nicholas Kofi Adjei
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
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Reynolds CW, Horton M, Anankware JP, Perosky J, Lee H, Nyanplu A, Zogbaye B, Kofa A, Lori JR. Sustainable palm weevil farming as nutrition supplementation at maternity waiting homes in Liberia. BMC Public Health 2022; 22:1313. [PMID: 35804358 PMCID: PMC9270802 DOI: 10.1186/s12889-022-13706-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Food insecurity is a global health challenge exacerbated by COVID-19. In Liberia, two-thirds of pregnant women are anemic, one-third of children are stunted, and 70% of households experienced food insecurity due to COVID-19. Edible insects are a nutritious, environmentally responsible, and cost-effective dietary supplement used throughout sub-Saharan Africa. Rearing palm weevil insects at maternity waiting homes (MWHs)-residential dwellings near hospitals where pregnant women await childbirth and receive postpartum services-could serve as a nutritious supplement for expectant mothers in Liberia and provide an income generating activity for MWHs. METHODS Following a one-day training, sixteen participants established palm weevil rearing sites at four MWHs in Liberia. Pre- and post-knowledge scores were assessed immediately prior to and following training. Pre-and post-knowledge scores were analyzed using paired t-test. Participants tracked two palm weevil rearing cycles (four months), using harvest amounts, turnover, barriers to implementation, and income generated as metrics. The number of women attending MWHs was recorded throughout the study period (July-December 2020). RESULTS Sixteen participants from four MWHs completed the training and two rearing cycles (four months) successfully. All participants showed statistically significant increases in knowledge scores following the one-day workshop with a pre-test score of 2.31 and post-test score of 7.75 out of 10 (p < 0.001). Over the 6-month study, 217 women stayed in four MWHs. Larval production from the various rearing centers ranged from 120 to 721 larvae, with all four sites producing enough palm weevil to sustain MWH residents who desired to consume the insects. One site successfully commercialized its harvest to sell approximately 50% for a total of 2,000 LD (13 USD) in income. Three of the four sites continued edible insect production beyond the four-month study period. CONCLUSIONS An edible insect project using palm weevil larva is one promising intervention as a nutrition supplement for expectant mothers at pre-established MWHs in rural Liberia. Edible insect rearing also has potential as an income generating activity for MWHs. Future studies should focus on addressing common barriers of remote implementation and metric tracking during the COVID-19 pandemic and reinforcing infrastructure to protect larvae rearing supplies.
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Affiliation(s)
| | - Madison Horton
- University of Michigan School of Nursing, Ann Arbor, MI USA
| | - Jacob Paarechuga Anankware
- Department of Horticulture and Crop Production, School of Agriculture and Technology, University of Energy and Natural Resources, Bono region, Ghana
- AnePare Farms, Sunyani, Bono region Ghana
| | | | - HaEun Lee
- Center for Global Health Equity, University of Michigan, Ann Arbor, MI USA
| | | | - Barsee Zogbaye
- Bong County Health Team, Suakoko District, Bong County, Liberia
| | - Alphonso Kofa
- Bong County Health Team, Suakoko District, Bong County, Liberia
| | - Jody R. Lori
- University of Michigan School of Nursing, Ann Arbor, MI USA
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11
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Pashaei Z, Oskouie F, Moradi-Lakeh M, Jahanfar S, Haghani S. HIV serostatus disclosure to sexual partner: a survey among women in Tehran, Iran. Eur J Med Res 2022; 27:56. [PMID: 35395935 PMCID: PMC8994217 DOI: 10.1186/s40001-022-00663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disclosure of HIV-positive status in women is associated with many factors. Consequently, status disclosure remains a challenge for Iranian women living with HIV. This study aimed to assess the prevalence, related factors, and reflections of HIV-positive status disclosure to a sexual partner(s) among Iranian women living with HIV. METHODS A cross-sectional study was conducted on 170 HIV-seropositive women. Participants were selected from patients registered in the largest HIV clinic and HIV-positive club of Iran. The "HIV disclosure" questionnaire had 38-items and all the interviews were administered by the researcher. Data were analyzed using SPSS version 21.0 software. We used a logistic regression method to calculate the crude odds ratio (COR) and the adjusted odds ratio (AOR) for self-disclosure as the independent predictor variable and the dependent variable, respectively. RESULTS One hundred and seventy HIV-positive women were enrolled. Most of them had disclosed their HIV status to at least one person (94.1%) and their sexual partners (86.5%). In the univariate analysis, being married (COR = 18.66, 95% CI 5.63-61.87), living with a sexual partner (COR = 4.72, 95% CI 1.92-11.62), being aware of sexual partners' HIV status (COR = 6.20, 95% CI 1.79-21.49), and gaining the support of sexual partner (COR = 9.08, 95% CI 3.48-23.64) were associated with higher odds of HIV status disclosure. In the multivariate analysis, being aware of sexual partners' HIV status, and gaining the support of sexual partners remained associated with HIV status disclosure. Most women reported a positive reflection from their sexual partners after disclosure, however, negative reflections from society were more common compared to sexual partners and family members. CONCLUSION This study shows high overall HIV disclosure proportions. It should be noted that a large number of women were infected by their sexual partners, especially by their spouses. The high rate of transmission in married people indicates an urgent need for more emphasis on appropriate prevention behaviors by infected partners.
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Affiliation(s)
- Zahra Pashaei
- Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.,Iranian Research Center for HIV/AIDS (IRCHA), Iran Nursing Care, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Oskouie
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran. .,Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shayesteh Jahanfar
- MPH Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, USA
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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12
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Daundasekara SS, Schuler B, Hernandez DC. Independent and combined associations of intimate partner violence and food insecurity on maternal depression and generalized anxiety disorder. J Anxiety Disord 2022; 87:102540. [PMID: 35192977 DOI: 10.1016/j.janxdis.2022.102540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
While research has investigated intimate partner violence (IPV) and food insecurity (FI) as independent experiences on mental health, research is lacking on the possible longitudinal associations of combined experiences of IPV and FI on maternal depression and generalized anxiety disorder (GAD). Using data from the Fragile Families and Child Wellbeing study (n = 1440), the current study examined the independent and combined associations of IPV and FI mothers experienced 3-5 years after their child's birth on depression and GAD at Year 15. Five mutually exclusive dichotomous variables were created based on IPV and FI experiences during Year 3 and Year 5. Depression and GAD were measured at Year 15 using the Composite International Diagnostic Interview-Short Form. According to the covariate-adjusted logistic regression models, exposure to IPV and FI, both concurrently and independently predicted greater depression at Year 15. Mothers in all IPV and FI categories had greater odds of having GAD at Year 15 compared to those with no exposure. Compared to the independent effect of IPV and FI, the combined effect of IPV and FI was highly associated with maternal GAD, but not depression. Using a trauma-informed approach to counseling in combination with food assistance programs might be an effective strategy in preventing mental health symptoms.
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Affiliation(s)
- Sajeevika Saumali Daundasekara
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Houston, TX 77030, USA.
| | - Brittany Schuler
- School of Social Work, Temple University, Ritter Annex 549, 1301 Cecil B. Moore Ave., Philadelphia, PA 19122, USA.
| | - Daphne C Hernandez
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Houston, TX 77030, USA.
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13
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Harsono D, Peterson H, Nyhan K, Khoshnood K. Factors associated with HIV acquisition in the context of humanitarian crises: a scoping review protocol. JBI Evid Synth 2022; 20:1852-1860. [PMID: 35249997 PMCID: PMC10395317 DOI: 10.11124/jbies-21-00135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review is to describe the global evidence on factors associated with HIV acquisition among individuals affected by humanitarian crises. INTRODUCTION Humanitarian crises are described as an event or series of events originating from natural causes or human intervention that represents a critical threat to the health, safety, security, and well-being of a community. Humanitarian crises have generated a continued rise in the number of displaced persons worldwide. This forcible displacement may increase the risk of acquiring human immunodeficiency virus (HIV) among the affected populations through poverty, food insecurity, social instability, and lack of access to health services during and after a crisis. Understanding factors that may contribute to HIV acquisition among these populations will allow stakeholders to be better equipped in providing HIV prevention services and programs in humanitarian settings and to prioritize research efforts. INCLUSION CRITERIA This review will consider studies containing empirical data published in peer-reviewed and gray literature that investigate factors associated with HIV acquisition in populations affected by humanitarian crises caused by natural disasters and human-made complex emergencies. METHODS MEDLINE, Embase, Global Health (all accessed via Ovid), Scopus, and gray literature will be systematically searched. Studies published in English from 1990 will be included. Titles and abstracts of identified citations will be screened independently and assessed for eligibility by two authors. Potentially relevant full-text studies and data will be extracted by these authors using a data extraction form. Data will be presented in tabular form, figures, and a narrative summary.
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Affiliation(s)
- Dini Harsono
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, USA Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
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14
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Daundasekara SS, Schuler BR, Hernandez DC. RETRACTED: Independent and combined associations of intimate partner violence and food insecurity on maternal depression and generalized anxiety disorder. J Anxiety Disord 2021; 81:102409. [PMID: 33932633 DOI: 10.1016/j.janxdis.2021.102409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/28/2020] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Sajeevika Saumali Daundasekara
- Department of Health, & Health Performance, University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX, 77204-6015, United States.
| | - Brittany R Schuler
- School of Social Work, Temple University, Ritter Annex 549, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, United States.
| | - Daphne C Hernandez
- University of Texas Health Science Center, Cizik School of Nursing, 6901 Bertner Avenue, Houston, TX, 77030-3901, United States.
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15
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Callands TA, Gilliam SM, Sileo KM, Taylor EN, Hunter-Jones JJ, Hansen NB. Examining the Influence of Trauma Exposure on HIV Sexual Risk Between Men and Women in Post-Conflict Liberia. AIDS Behav 2021; 25:1159-1170. [PMID: 33180254 PMCID: PMC7979480 DOI: 10.1007/s10461-020-03088-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 11/25/2022]
Abstract
The adverse impact of exposure to war-related traumatic events on mental health is well documented. Few studies, however, have focused on the impact of exposure to war-related traumatic events on HIV sexual risk behavior in post-conflict countries such as Liberia. We investigated whether exposure to war-related traumatic events was linked to HIV sexual risk behavior, and identified potential mediators of this relationship, including stressful life events, problematic alcohol use, and intimate partner violence (IPV) among women and men in Liberia. Data were collected from a sample of 395 participants in Monrovia, Liberia. Results from the serial multiple mediator model did not support direct or indirect effects between war-related traumatic events and HIV sexual risk behavior among women. For men, we found both direct and indirect effects between war-related traumatic events and HIV sexual risk behavior. Findings from this research highlight the need for trauma-informed HIV prevention strategies in Liberia.
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Affiliation(s)
- Tamora A Callands
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, 100 Foster Rd, Wright Hall, Athens, GA, 321D30602-6522, USA.
| | - Shantesica M Gilliam
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, 100 Foster Rd, Wright Hall, Athens, GA, 321D30602-6522, USA
| | - Katelyn M Sileo
- Department of Public Health, College of Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
- The Center for Interdisciplinary Research at Yale University, New Haven, CT, USA
| | - Erica N Taylor
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, 100 Foster Rd, Wright Hall, Athens, GA, 321D30602-6522, USA
| | - Josalin J Hunter-Jones
- School of Social Work, College of Health and Human Sciences, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Nathan B Hansen
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, 100 Foster Rd, Wright Hall, Athens, GA, 321D30602-6522, USA
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16
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Hatcher AM, Weiser SD, Cohen CR, Hagey J, Weke E, Burger R, Wekesa P, Sheira L, Frongillo EA, Bukusi EA. Food Insecurity and Intimate Partner Violence Among HIV-Positive Individuals in Rural Kenya. Am J Prev Med 2021; 60:563-568. [PMID: 33012622 PMCID: PMC7987870 DOI: 10.1016/j.amepre.2020.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Intimate partner violence and food insecurity are both structural drivers of HIV acquisition, care, and treatment, but little is known about how the 2 conditions intersect in the lives of those already living with HIV. METHODS This study examined cross-sectional baseline data (collected in January 2016-December 2017) from an ongoing trial in southwestern Kenya. Trained interviewers asked enrolled participants living with HIV aged 18-60 years about household food insecurity (using the Household Food Insecurity Access Scale), intimate partner violence (using an adapted WHO multicountry study instrument), and sociodemographics. Negative binomial regression was used to examine the association between food insecurity and partner violence victimization (among women) or perpetration (among men). Secondary data were analyzed in August 2019-March 2020. RESULTS Of 720 participants, more than half of women reported experiencing intimate partner violence (57.6%) and most men reported perpetrating it (58.4%). Participants reporting any partner violence had higher Household Food Insecurity Access Scale scores (21.8) compared with those reporting no violence (21.3, p=0.02). Each categorical change in food insecurity (mild, moderate, severe) was associated with a 41% increased risk of an additional partner violence episode. In models controlling for relationship status, wealth, season of interview (lean versus not lean), and baseline physical health, each 1-point increase in food insecurity was associated with a 6% higher risk of violence victimization among women and 4% greater risk of men perpetrating partner violence. CONCLUSIONS This study highlights the interconnected nature of intimate partner violence and food insecurity among women and men living with HIV. This relationship suggests that enhancing food security may be a useful intervention strategy to prevent intimate partner violence and improve HIV-related health outcomes.
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Affiliation(s)
- Abigail M Hatcher
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California; Faculty of Health Science, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Craig R Cohen
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Jill Hagey
- Department of Medicine, Duke University, Durham, North Carolina
| | - Elly Weke
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rachel Burger
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Pauline Wekesa
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Lila Sheira
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Elizabeth A Bukusi
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California; Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Department of Global Health, University of Washington, Seattle, Washington; Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
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17
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Jesson J, Dietrich J, Beksinska M, Closson K, Nduna M, Smit J, Brockman M, Ndung'u T, Gray G, Kaida A. Food insecurity and depression: a cross-sectional study of a multi-site urban youth cohort in Durban and Soweto, South Africa. Trop Med Int Health 2021; 26:687-700. [PMID: 33666301 DOI: 10.1111/tmi.13572] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the prevalence of food insecurity and the independent association between depression and food insecurity among youth living in two urban settings in South Africa. METHODS Baseline cross-sectional survey data was analysed from a prospective cohort study conducted between 2014 and 2016 among youth (aged 16-24 years) in Soweto and Durban. Interviewer-administered questionnaires collecting socio-demographic, sexual and reproductive health and mental health data were conducted. Household food insecurity was measured using the 3-item Household Hunger Scale, with food insecure participants defined as having 'moderate' or 'severe hunger' compared to 'no hunger'. Depression was assessed using the 10-item Center for Epidemiological Studies Depression (CES-D 10) Scale (range 0-30, probable depression ≥ 10). Multivariable logistic regression models were used to estimate the association between depression and food insecurity. RESULTS There were 422 participants. Median age was 19 years (interquartile range [IQR] 18-21) and 60% were women. Overall, 18% were food insecure and 42% had probable depression. After adjustment for socio-demographic variables (age, gender, female-headed household, household size and school enrolment), participants with probable depression had higher odds of being food insecure than non-depressed participants (2.79, 95%CI 1.57-4.94). CONCLUSION Nearly one-fifth of youth in this study were food insecure. Those with probable depression had increased odds of food insecurity. Interventions are needed to address food insecurity among urban youth in South Africa, combining nutritional support and better access to quality food with mental health support.
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Affiliation(s)
- Julie Jesson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Mags Beksinska
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Kalysha Closson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mzikazi Nduna
- Department of Psychology, University of the Witwatersrand, Johannesburg, South Africa
| | - Jenni Smit
- Maternal Adolescent and Child Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Thumbi Ndung'u
- HIV Pathogenesis Programme and Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa.,Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA.,Max Planck Institute for Infection Biology, Berlin, Germany.,Division of Infection and Immunity, University College London, London, UK
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Office of the President, South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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Benzekri NA, Sambou JF, Ndong S, Diallo MB, Tamba IT, Faye D, Diatta JP, Faye K, Sall I, Sall F, Cisse O, Malomar JJ, Ndour CT, Sow PS, Hawes SE, Seydi M, Gottlieb GS. Food insecurity predicts loss to follow-up among people living with HIV in Senegal, West Africa. AIDS Care 2021; 34:878-886. [PMID: 33682545 PMCID: PMC8937041 DOI: 10.1080/09540121.2021.1894316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The goals of this study were to assess retention on antiretroviral therapy (ART) and to identify predictors of loss to follow-up (LTFU) among people living with HIV (PLHIV) in Senegal. HIV-positive individuals presenting for initiation of ART in Dakar and Ziguinchor were enrolled and followed for 12 months. Data were collected using interviews, clinical evaluations, laboratory analyses, chart review, and active patient tracing. Of the 207 individuals enrolled, 70% were female, 32% had no formal education, and 28% were severely food insecure. At the end of the follow-up period, 58% were retained on ART, 15% were deceased, 4% had transferred care, 5% had migrated, and 16% were lost to follow-up. Enrollment in Ziguinchor (OR 2.71 [1.01–7.22]) and severe food insecurity (OR 2.55 [1.09–5.96]) were predictive of LTFU. Sex, age, CD4 count, BMI <18.5, country of birth, marital status, number of children, household size, education, consultation with traditional healers, transportation time, and transportation cost were not associated with LTFU. The strongest predictor of severe food insecurity was lack of formal education (OR 2.75 [1.30–5.80]). Addressing the upstream drivers of food insecurity and implementing strategies to enhance food security for PLHIV may be effective approaches to reduce LTFU and strengthen the HIV care cascade in the region.
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Affiliation(s)
| | | | - Sanou Ndong
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Mouhamadou Baïla Diallo
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | | | | | | | - Khadim Faye
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | | | - Fatima Sall
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | | | | | - Cheikh T Ndour
- Division de Lutte contre le Sida et les IST, Ministère de la Santé et de l'Action Sociale, Dakar, Senegal
| | - Papa Salif Sow
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, Seattle, WA, USA
| | - Moussa Seydi
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Geoffrey S Gottlieb
- Department of Medicine, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, Seattle, WA, USA
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19
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Benzekri NA, Sambou JF, Ndong S, Diallo MB, Tamba IT, Faye D, Sall I, Diatta JP, Faye K, Cisse O, Sall F, Guèye NFN, Ndour CT, Sow PS, Malomar JJ, Hawes SE, Seydi M, Gottlieb GS. The impact of food insecurity on HIV outcomes in Senegal, West Africa: a prospective longitudinal study. BMC Public Health 2021; 21:451. [PMID: 33676463 PMCID: PMC7936446 DOI: 10.1186/s12889-021-10444-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the impact of food insecurity on HIV outcomes is critical for the development and implementation of effective, evidence-based interventions to address food insecurity and improve the HIV care cascade. We conducted a prospective, longitudinal study to determine the impact of food insecurity on HIV outcomes in Senegal, West Africa. METHODS HIV-infected individuals presenting for care and initiation of ART through the Senegalese National AIDS program in Dakar and Ziguinchor were eligible for enrollment. Data were collected using interviews, clinical evaluations, laboratory analyses, and chart review at enrollment, month 6, and month 12. Logistic regression was used to determine the association between food insecurity and HIV outcomes. RESULTS Among the 207 participants in this study, 70% were female and the median age was 37 years. The majority (69%) were food insecure at enrollment, 29% were severely food insecure, and 38% were undernourished. Nearly a third (32%) had no formal education, 23% practiced agriculture, and 40% owned livestock. The median daily food expenditure per person was $0.58. The median round trip transportation time to clinic was 90 min (IQR 30-240). The median cost of transportation to clinic was $1.74. At month 12, 69% were food insecure, 23% were severely food insecure, and 14% were undernourished. At month 12, 43% had not disclosed their HIV status; food insecurity was associated with non-disclosure of HIV-status due to fear of stigmatization and feelings of shame. Severe food insecurity was a strong predictor of loss to follow-up (OR 3.13 [1.08-9.06]) and persistent severe food insecurity was associated with virologic failure (OR 5.14 [1.01-26.29]) and poor adherence to ART 8.00 [1.11-57.57]. Poor nutritional status was associated with poor immunologic recovery (OR 4.24 [1.56-11.47]), virologic failure (OR 3.39 [1.13-10.21]), and death (OR 3.35 [1.40-8.03]). CONCLUSION Severity and duration of food insecurity are important factors in understanding the relationship between food insecurity and HIV outcomes. Our findings highlight the importance of nutritional status, socioeconomic opportunity, and self-stigmatization in the complex pathway between food insecurity and HIV outcomes. Interdisciplinary, multisectoral efforts are needed to develop and implement effective interventions to address food insecurity among people living with HIV.
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Affiliation(s)
- Noelle A Benzekri
- Department of Medicine, University of Washington, Box 358061, 750 Republican St., Seattle, WA, 98109-4725, USA.
| | | | - Sanou Ndong
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Mouhamadou Baïla Diallo
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | | | | | | | | | - Khadim Faye
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | | | - Fatima Sall
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Ndèye Fatou Ngom Guèye
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Cheikh T Ndour
- Division de Lutte contre le Sida et les IST, Ministère de la Santé et de l'Action Sociale, Dakar, Senegal
| | - Papa Salif Sow
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | | | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Moussa Seydi
- Services des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Geoffrey S Gottlieb
- Department of Medicine, University of Washington, Box 358061, 750 Republican St., Seattle, WA, 98109-4725, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
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20
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Willie TC, Alexander KA, Caplon A, Kershaw TS, Safon CB, Galvao RW, Kaplan C, Caldwell A, Calabrese SK. Birth Control Sabotage as a Correlate of Women's Sexual Health Risk: An Exploratory Study. Womens Health Issues 2021; 31:157-163. [PMID: 33218751 PMCID: PMC8005431 DOI: 10.1016/j.whi.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 09/15/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION To explore associations between birth control sabotage, a form of reproductive coercion, and women's sexual risk among women attending family planning health centers. Data were collected from a 2017 cross-sectional online survey of 675 women who attended Connecticut Planned Parenthood centers. Participants reported birth control sabotage; sexual risk (i.e., inconsistent condom use during vaginal and anal sex in the past 6 months, lifetime sexually transmitted infection diagnosis, lifetime exchange sex [trading sex for money, drugs, or other goods], and multiple sexual partners in the past 6 months); and sociodemographics. Bivariate and multivariable logistic regression models were used to examine associations between birth control sabotage and women's sexual risk. RESULTS One in six women (16.4%; n = 111) reported experiencing birth control sabotage. Women who reported birth control sabotage had a greater odds of ever having an sexually transmitted infection (adjusted odds ratio, 2.18; 95% confidence interval, 1.31-3.60; p = .003), ever engaging in exchange sex (adjusted odds ratio, 2.77; 95% confidence interval, 1.17-6.53; p = .020), and having multiple sexual partners in the past 6 months (adjusted odds ratio, 1.96; 95% confidence interval, 1.21-3.18; p = .006). CONCLUSIONS Our findings demonstrate increased engagement in sexual risk taking among women who reported birth control sabotage compared with women did not.
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Affiliation(s)
- Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Kamila A Alexander
- Department of Community Public Health Nursing, Johns Hopkins School of Nursing, Baltimore, Maryland
| | - Amy Caplon
- Division of Cancer Control and Populations Sciences, National Cancer Institute, Rockville, Maryland
| | - Trace S Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Cara B Safon
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Rachel W Galvao
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Clair Kaplan
- Planned Parenthood of Southern New England, New Haven, Connecticut
| | - Abigail Caldwell
- Planned Parenthood of Southern New England, New Haven, Connecticut
| | - Sarah K Calabrese
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC
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