The social context of food insecurity among persons living with HIV/AIDS in rural Uganda
HIV/AIDS and food insecurity are two of the leading causes of morbidity and mortality in sub-Saharan Africa, with each heightening the vulnerability to, and worsening the severity of, the other. Less research has focused on the social determinants of food insecurity in resource-limited settings, including social support and HIV-related stigma. In this study, we analyzed data from a cohort of 456 persons from the Uganda AIDS Rural Treatment Outcomes study, an ongoing prospective cohort of persons living with HIV/AIDS (PLWHA) initiating HIV antiretroviral therapy in Mbarara, Uganda. Quarterly data were collected by structured interviews. The primary outcome, food insecurity, was measured with the Household Food Insecurity Access Scale. Key covariates of interest included social support, internalized HIV-related stigma, HIV-related enacted stigma, and disclosure of HIV serostatus. Severe food insecurity was highly prevalent overall (38%) and more prevalent among women than among men. Social support, HIV disclosure, and internalized HIV-related stigma were associated with food insecurity; these associations persisted after adjusting for household wealth, employment status, and other previously identified correlates of food insecurity. The adverse effects of internalized stigma persisted in a lagged specification, and the beneficial effect of social support further persisted after the inclusion of fixed effects. International organizations have increasingly advocated for addressing food insecurity as part of HIV/AIDS programming to improve morbidity and mortality. This study provides quantitative evidence on social determinants of food insecurity among PLWHA in resource-limited settings and suggests points of intervention. These findings also indicate that structural interventions to improve social support and/or decrease HIV-related stigma may also improve the food security of PLWHA.
Volume (Year): 73 (2011)
Issue (Month): 12 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Tirivayi, Nyasha & Groot, Wim, 2011. "Health and welfare effects of integrating AIDS treatment with food assistance in resource constrained settings: A systematic review of theory and evidence," Social Science & Medicine, Elsevier, vol. 73(5), pages 685-692, September.
- Masanjala, Winford, 2007. "The poverty-HIV/AIDS nexus in Africa: A livelihood approach," Social Science & Medicine, Elsevier, vol. 64(5), pages 1032-1041, March.
- Stefan Dercon & Pramila Krishnan, 1997.
"In sickness and in health... risk-sharing within households in rural Ethiopia,"
Economics Series Working Papers
WPS/1997-12, University of Oxford, Department of Economics.
- Stefan Dercon & Pramila Krishnan, 2000. "In Sickness and in Health: Risk Sharing within Households in Rural Ethiopia," Journal of Political Economy, University of Chicago Press, vol. 108(4), pages 688-727, August.
- Pramila Krishnan & Stefan Dercon, 1997. "In sickness and in health ... risk-sharing within households in rural Ethiopia," CSAE Working Paper Series 1997-12, Centre for the Study of African Economies, University of Oxford.
- Eliana La Ferrara, 2003.
"Kin Groups and Reciprocity: A Model of Credit Transactions in Ghana,"
American Economic Review,
American Economic Association, vol. 93(5), pages 1730-1751, December.
- La Ferrara, Eliana, 2003. "Kin Groups and Reciprocity: A Model of Credit Transactions in Ghana," CEPR Discussion Papers 3705, C.E.P.R. Discussion Papers.
- Hosegood, Victoria & Preston-Whyte, Eleanor & Busza, Joanna & Moitse, Sindile & Timaeus, Ian M., 2007. "Revealing the full extent of households' experiences of HIV and AIDS in rural South Africa," Social Science & Medicine, Elsevier, vol. 65(6), pages 1249-1259, September.
- Behrman, Jere R, 1988. "Intrahousehold Allocation of Nutrients in Rural India: Are Boys Favored? Do Parents Exhibit Inequality Aversion?," Oxford Economic Papers, Oxford University Press, vol. 40(1), pages 32-54, March.
- Danziger, Renee, 1994. "The social impact of HIV/AIDS in developing countries," Social Science & Medicine, Elsevier, vol. 39(7), pages 905-917, October.
- Rose, Donald & Gunderson, Craig & Oliveira, Victor, 1998. "Socio-Economic Determinants of Food Insecurity in the United States: Evidence from the SIPP and CSFII Datasets," Technical Bulletins 184377, United States Department of Agriculture, Economic Research Service.
- Abadía-Barrero, César Ernesto & Castro, Arachu, 2006. "Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil," Social Science & Medicine, Elsevier, vol. 62(5), pages 1219-1228, March.
- Carter, Michael R. & Maluccio, John A., 2003. "Social Capital and Coping with Economic Shocks: An Analysis of Stunting of South African Children," World Development, Elsevier, vol. 31(7), pages 1147-1163, July.
- Yamano, Takashi & Jayne, T. S., 2004. "Measuring the Impacts of Working-Age Adult Mortality on Small-Scale Farm Households in Kenya," World Development, Elsevier, vol. 32(1), pages 91-119, January.
- Antony Chapoto & T. S. Jayne, 2008. "Impact of AIDS-Related Mortality on Farm Household Welfare in Zambia," Economic Development and Cultural Change, University of Chicago Press, vol. 56, pages 327-374.
- Stefan Dercon & Joachim De Weerdt, 2002.
"Risk-sharing networks and insurance against illness,"
CSAE Working Paper Series
2002-16, Centre for the Study of African Economies, University of Oxford.
- De Weerdt, Joachim & Dercon, Stefan, 2006. "Risk-sharing networks and insurance against illness," Journal of Development Economics, Elsevier, vol. 81(2), pages 337-356, December.
- Stefan Dercon & Joachim De Weerdt, 2002. "Risk-sharing Networks and Insurance against illness," Economics Series Working Papers WPS/2002-16, University of Oxford, Department of Economics.
- Stefan Dercon & Joachim de Weerdt, 2004. "Risk-Sharing Networks And Insurance Against Illness," Development and Comp Systems 0409019, EconWPA.
- Mak, Winnie W.S. & Cheung, Rebecca Y.M. & Law, Rita W. & Woo, Jean & Li, Patrick C.K. & Chung, Rita W.Y., 2007. "Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS," Social Science & Medicine, Elsevier, vol. 64(8), pages 1549-1559, April.
- Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer, vol. 38(1), pages 115-132, February.
- Genberg, Becky L. & Hlavka, Zdenek & Konda, Kelika A. & Maman, Suzanne & Chariyalertsak, Suwat & Chingono, Alfred & Mbwambo, Jessie & Modiba, Precious & Van Rooyen, Heidi & Celentano, David D., 2009. "A comparison of HIV/AIDS-related stigma in four countries: Negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS," Social Science & Medicine, Elsevier, vol. 68(12), pages 2279-2287, June.
- Elaina Rose, 1999. "Consumption Smoothing and Excess Female Mortality in Rural India," The Review of Economics and Statistics, MIT Press, vol. 81(1), pages 41-49, February.
- Dean, Wesley R. & Sharkey, Joseph R., 2011. "Food insecurity, social capital and perceived personal disparity in a predominantly rural region of Texas: An individual-level analysis," Social Science & Medicine, Elsevier, vol. 72(9), pages 1454-1462, May.
- Berkman, Lisa F. & Glass, Thomas & Brissette, Ian & Seeman, Teresa E., 2000. "From social integration to health: Durkheim in the new millennium," Social Science & Medicine, Elsevier, vol. 51(6), pages 843-857, September.
- Feigenberg, Benjamin & Field, Erica Marie & Pande, Rohini, 2010.
"Building Social Capital Through Microfinance,"
4449105, Harvard Kennedy School of Government.
- Benjamin Feigenberg & Erica M. Field & Rohini Pande, 2010. "Building Social Capital Through MicroFinance," NBER Working Papers 16018, National Bureau of Economic Research, Inc.
- Feigenberg, Benjamin & Field, Erica M. & Pande, Rohini, 2010. "Building Social Capital through Microfinance," Working Paper Series rwp10-019, Harvard University, John F. Kennedy School of Government.
- Pronyk, Paul M. & Harpham, Trudy & Busza, Joanna & Phetla, Godfrey & Morison, Linda A. & Hargreaves, James R. & Kim, Julia C. & Watts, Charlotte H. & Porter, John D., 2008. "Can social capital be intentionally generated? A randomized trial from rural South Africa," Social Science & Medicine, Elsevier, vol. 67(10), pages 1559-1570, November.
- Steward, Wayne T. & Herek, Gregory M. & Ramakrishna, Jayashree & Bharat, Shalini & Chandy, Sara & Wrubel, Judith & Ekstrand, Maria L., 2008. "HIV-related stigma: Adapting a theoretical framework for use in India," Social Science & Medicine, Elsevier, vol. 67(8), pages 1225-1235, October.
- Froot, Kenneth A., 1989. "Consistent Covariance Matrix Estimation with Cross-Sectional Dependence and Heteroskedasticity in Financial Data," Journal of Financial and Quantitative Analysis, Cambridge University Press, vol. 24(03), pages 333-355, September.
- Locher, Julie L. & Ritchie, Christine S. & Roth, David L. & Baker, Patricia Sawyer & Bodner, Eric V. & Allman, Richard M., 2005. "Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences," Social Science & Medicine, Elsevier, vol. 60(4), pages 747-761, February.
- Martin, Katie S & Rogers, Beatrice L & Cook, John T & Joseph, Hugh M, 2004. "Social capital is associated with decreased risk of hunger," Social Science & Medicine, Elsevier, vol. 58(12), pages 2645-2654, June.
- Simbayi, Leickness C. & Kalichman, Seth & Strebel, Anna & Cloete, Allanise & Henda, Nomvo & Mqeketo, Ayanda, 2007. "Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa," Social Science & Medicine, Elsevier, vol. 64(9), pages 1823-1831, May.
- Maes, Kenneth C. & Hadley, Craig & Tesfaye, Fikru & Shifferaw, Selamawit, 2010. "Food insecurity and mental health: Surprising trends among community health volunteers in Addis Ababa, Ethiopia during the 2008 food crisis," Social Science & Medicine, Elsevier, vol. 70(9), pages 1450-1457, May.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:73:y:2011:i:12:p:1717-1724. See general information about how to correct material in RePEc.
If references are entirely missing, you can add them using this form.