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.
Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, California.
Am J Prev Med. 2021 Apr;60(4):563-568. doi: 10.1016/j.amepre.2020.06.025. Epub 2020 Oct 1.
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.
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.
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.
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.
亲密伴侣暴力和粮食不安全都是艾滋病毒感染、护理和治疗的结构性驱动因素，但对于这两种情况在已经感染艾滋病毒的人群生活中是如何交叉的，人们知之甚少。
本研究检查了来自肯尼亚西南部一项正在进行的试验的横断面基线数据（于 2016 年 1 月至 2017 年 12 月收集）。经过培训的访谈者询问了登记的年龄在 18 至 60 岁之间的艾滋病毒感染者，询问了他们家庭粮食不安全状况（使用家庭粮食不安全评估量表）、亲密伴侣暴力（使用经过改编的世卫组织多国家研究工具）和社会人口统计学信息。使用负二项回归检验粮食不安全与女性遭受亲密伴侣暴力侵害或男性实施亲密伴侣暴力之间的关联。二级数据于 2019 年 8 月至 2020 年 3 月进行分析。
在 720 名参与者中，超过一半的女性报告遭受亲密伴侣暴力（57.6%），大多数男性报告实施亲密伴侣暴力（58.4%）。报告遭受任何亲密伴侣暴力的参与者的家庭粮食不安全评估量表得分（21.8）高于未报告遭受暴力的参与者（21.3，p=0.02）。粮食不安全状况（轻度、中度、重度）每发生一次变化，发生另外一次亲密伴侣暴力事件的风险就会增加 41%。在控制了关系状况、财富、访谈季节（消瘦期与非消瘦期）和基线身体健康状况的模型中，粮食不安全程度每增加 1 分，女性遭受暴力侵害的风险就会增加 6%，男性实施亲密伴侣暴力的风险就会增加 4%。
本研究强调了艾滋病毒感染者中女性和男性之间亲密伴侣暴力和粮食不安全的相互关联性质。这种关系表明，增强粮食安全可能是预防亲密伴侣暴力和改善艾滋病毒相关健康结果的有用干预策略。
