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Poverty, Food Insufficiency and HIV Infection and Sexual Behaviour among Young Rural Zimbabwean Women

Author

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  • Sophie J S Pascoe
  • Lisa F Langhaug
  • Webster Mavhu
  • James Hargreaves
  • Shabbar Jaffar
  • Richard Hayes
  • Frances M Cowan

Abstract

Background: Despite a recent decline, Zimbabwe still has the fifth highest adult HIV prevalence in the world at 14.7%; 56% of the population are currently living in extreme poverty. Design: Cross-sectional population-based survey of 18–22 year olds, conducted in 30 communities in south-eastern Zimbabwe in 2007. Objective: To examine whether the risk of HIV infection among young rural Zimbabwean women is associated with socio-economic position and whether different socio-economic domains, including food sufficiency, might be associated with HIV risk in different ways. Methods: Eligible participants completed a structured questionnaire and provided a finger-prick blood sample tested for antibodies to HIV and HSV-2. The relationship between poverty and HIV was explored for three socio-economic domains: ability to afford essential items; asset wealth; food sufficiency. Analyses were performed to examine whether these domains were associated with HIV infection or risk factors for infection among young women, and to explore which factors might mediate the relationship between poverty and HIV. Results: 2593 eligible females participated in the survey and were included in the analyses. Overall HIV prevalence among these young females was 7.7% (95% CI: 6.7–8.7); HSV-2 prevalence was 11.2% (95% CI: 9.9–12.4). Lower socio-economic position was associated with lower educational attainment, earlier marriage, increased risk of depression and anxiety disorders and increased reporting of higher risk sexual behaviours such as earlier sexual debut, more and older sexual partners and transactional sex. Young women reporting insufficient food were at increased risk of HIV infection and HSV-2. Conclusions: This study provides evidence from Zimbabwe that among young poor women, economic need and food insufficiency are associated with the adoption of unsafe behaviours. Targeted structural interventions that aim to tackle social and economic constraints including insufficient food should be developed and evaluated alongside behaviour and biomedical interventions, as a component of HIV prevention programming and policy.

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  • Sophie J S Pascoe & Lisa F Langhaug & Webster Mavhu & James Hargreaves & Shabbar Jaffar & Richard Hayes & Frances M Cowan, 2015. "Poverty, Food Insufficiency and HIV Infection and Sexual Behaviour among Young Rural Zimbabwean Women," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-21, January.
    • Handle: RePEc:plo:pone00:0115290
    DOI: 10.1371/journal.pone.0115290
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    2. Rachel E. Baker, 2020. "Climate change drives increase in modeled HIV prevalence," Climatic Change, Springer, vol. 163(1), pages 237-252, November.
    3. Stoebenau, Kirsten & Heise, Lori & Wamoyi, Joyce & Bobrova, Natalia, 2016. "Revisiting the understanding of “transactional sex” in sub-Saharan Africa: A review and synthesis of the literature," Social Science & Medicine, Elsevier, vol. 168(C), pages 186-197.
    4. Kelly F. Austin & Mark D. Noble & Virginia Kuulei Berndt, 2021. "Drying Climates and Gendered Suffering: Links Between Drought, Food Insecurity, and Women’s HIV in Less-Developed Countries," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 154(1), pages 313-334, February.
    5. Rachid Muleia & Makini Boothe & Osvaldo Loquiha & Marc Aerts & Christel Faes, 2020. "Spatial Distribution of HIV Prevalence among Young People in Mozambique," IJERPH, MDPI, vol. 17(3), pages 1-20, January.
    6. Johannes Jakubik & Stefan Feuerriegel, 2022. "Data‐driven allocation of development aid toward sustainable development goals: Evidence from HIV/AIDS," Production and Operations Management, Production and Operations Management Society, vol. 31(6), pages 2739-2756, June.

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