Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 121 South Main Street, 2nd Floor, Providence, RI, 02903, USA.
Department of Allied Health Sciences and Department of Statistics, University of Connecticut, Storrs, CT, USA.
Arch Sex Behav. 2018 Oct;47(7):1899-1907. doi: 10.1007/s10508-017-0942-4. Epub 2017 Apr 20.
People living with HIV in poverty have limited tangible and mental resources coupled with competing demands for these resources. Competing demands require individuals to make choices that may be beneficial to them in the short term but not in the long term. Past research has shown that food insecurity is related to sexual risk behaviors among people living with HIV. Individuals who are food insecure may sell sex in order to obtain food or lack of food may lead to a depletion of mental resources to negotiate safe sex. Substance use may also create additional constraints on these already limited resources. The current study tested the relation between food insecurity and day-level sexual risk behavior and the possible mediating role that alcohol/substance use may play. Men and women living with HIV were enrolled in a 28-day prospective study between October 2012 and April 2014 in which they completed daily text message surveys regarding their sex behaviors and substance/alcohol use in the context of sex. A total of 796 participants reported sex on 3894 days. On days in which sex occurred, baseline food insecurity was negatively associated with daily condom use. There was also a significant effect of substance use in the context of sex on the rates of change in condom use over time, and this interaction between substance use and time was a partial mediator of the relation between food insecurity and condom use. Gender did not moderate this mediation. Situation-specific alcohol and drug use should be integrated into interventions that target food insecurity and HIV prevention.
生活贫困的艾滋病毒感染者拥有的有形和心理资源有限，而这些资源还存在竞争需求。竞争需求要求个人做出选择，这些选择可能在短期内对他们有利，但从长期来看并非如此。过去的研究表明，粮食不安全与艾滋病毒感染者的性风险行为有关。粮食不安全的人可能会卖淫来获取食物，或者缺乏食物可能会导致他们在谈判安全性行为时精神资源枯竭。物质使用也可能对这些已经有限的资源造成额外的限制。本研究检验了粮食不安全与日常性风险行为之间的关系，以及酒精/物质使用可能在其中发挥的中介作用。2012 年 10 月至 2014 年 4 月期间，艾滋病毒感染者男女被纳入一项为期 28 天的前瞻性研究，在此期间，他们完成了关于性行为和性活动中物质/酒精使用的每日短信调查。共有 796 名参与者报告了 3894 天的性行为。在发生性行为的日子里，基线粮食不安全与每日使用避孕套呈负相关。性活动中物质使用对避孕套使用的变化率也有显著影响，物质使用与时间之间的这种相互作用部分中介了粮食不安全与避孕套使用之间的关系。性别没有调节这种中介作用。应该将具体情况的酒精和毒品使用纳入针对粮食不安全和艾滋病毒预防的干预措施中。
