Advertisement

Food Insecurity and Intimate Partner Violence Among HIV-Positive Individuals in Rural Kenya

Published:October 01, 2020DOI:https://doi.org/10.1016/j.amepre.2020.06.025

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Singer M
        • Clair S
        Syndemics and public health: reconceptualizing disease in bio-social context.
        Med Anthropol Q. 2003; 17: 423-441
        • Singer M
        • Bulled N
        • Ostrach B
        • Mendenhall E
        Syndemics and the biosocial conception of health.
        Lancet. 2017; 389: 941-950
        • Li Y
        • Marshall CM
        • Rees HC
        • Nunez A
        • Ezeanolue EE
        • Ehiri JE
        Intimate partner violence and HIV infection among women: a systematic review and meta-analysis.
        J Int AIDS Soc. 2014; 17: 18845
        • Weiser SD
        • Palar K
        • Hatcher AM
        • Young SL
        • Frongillo EA
        Food insecurity and health: a conceptual framework.
        in: Ivers L Food Insecurity and Public Health. CRC Press, Boca Raton, FL2015: 23-50
        • Palar K
        • Laraia B
        • Tsai AC
        • Johnson MO
        • Weiser SD
        Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
        AIDS. 2016; 30: 1457-1465
        • Hatcher AM
        • Smout EM
        • Turan JM
        • Christofides N
        • Stöckl H
        Intimate partner violence and engagement in HIV care and treatment among women: a systematic review and meta-analysis.
        AIDS. 2015; 29: 2183-2194
        • Weiser SD
        • Young SL
        • Cohen CR
        • et al.
        Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS.
        Am J Clin Nutr. 2011; 94: 1729S-1739S
        • Devries KM
        • Mak JY
        • García-Moreno C
        • et al.
        Global health. The global prevalence of intimate partner violence against women.
        Science. 2013; 340: 1527-1528
        • FAO IFAD
        • UNICEF WFP
        • WHO. The State of Food Security and Nutrition in the World 2019
        Safeguarding against economic slowdowns and downturns.
        FAO, Rome, ItalyPublished 2019
        http://www.fao.org/3/ca5162en/ca5162en.pdf
        Date accessed: July 20, 2020
        • Breiding MJ
        • Basile KC
        • Klevens J
        • Smith SG
        Economic insecurity and intimate partner and sexual violence victimization.
        Am J Prev Med. 2017; 53: 457-464
        • Melchior H
        • Hergert A
        • Hofreuter-Gätgens K
        • et al.
        Predictors of treatment duration for inpatients with mental disorders–a systematic literature review [in German].
        Z Psychosom Med Psychother. 2010; 56: 399-418
        • Ricks JL
        • Cochran SD
        • Arah OA
        • Williams JK
        • Seeman TE
        Food insecurity and intimate partner violence against women: results from the California Women's Health Survey.
        Public Health Nutr. 2016; 19: 914-923
        • Diamond-Smith N
        • Conroy AA
        • Tsai AC
        • Nekkanti M
        • Weiser SD
        Food insecurity and intimate partner violence among married women in Nepal.
        J Glob Health. 2019; 9010412
        • Conroy AA
        • Cohen MH
        • Frongillo EA
        • et al.
        Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the U.S.
        PLoS One. 2019; 14e0213365
        • Derose KP
        • Payán DD
        • Fulcar MA
        • et al.
        Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
        PLoS One. 2017; 12e0181568
        • Hatcher AM
        • Stöckl H
        • McBride RS
        • Khumalo M
        • Christofides N
        Pathways from food insecurity to intimate partner violence perpetration among peri-urban men in South Africa.
        Am J Prev Med. 2019; 56: 765-772
        • Chirwa ED
        • Sikweyiya Y
        • Addo-Lartey AA
        • et al.
        Prevalence and risk factors of physical or sexual intimate violence perpetration amongst men in four districts in the central region of Ghana: baseline findings from a cluster randomised controlled trial.
        PLoS One. 2018; 13e0191663
        • Hatcher AM
        • Gibbs A
        • McBride RS
        • Rebombo D
        • Khumalo M
        • Christofides NJ
        Gendered syndemic of intimate partner violence, alcohol misuse, and HIV risk among peri-urban, heterosexual men in South Africa.
        Soc Sci Med. 2019; (In pressOnline October 22)
        • Connell RW
        • Messerschmidt JW
        Hegemonic masculinity: rethinking the concept.
        Gend Soc. 2005; 19: 829-859
        • Stets JE
        Job autonomy and control over one's spouse: a compensatory process.
        J Health Soc Behav. 1995; 36: 244-258
        • Fox GL
        • Benson ML
        • DeMaris AA
        • Wyk J
        Economic distress and intimate violence: testing family stress and resources theories.
        J Marriage Fam. 2002; 64: 793-807
        • Baumeister RF
        • Heatherton TF
        • Tice DM
        Losing Control: How and Why People Fail at Self-Regulation.
        Academic Press, Cambridge, MA1994
        • Lindhorst T
        • Oxford M
        • Gillmore MR
        Longitudinal effects of domestic violence on employment and welfare outcomes.
        J Interpers Violence. 2007; 22: 812-828
        • Peterson C
        • Kearns MC
        • McIntosh WL
        • et al.
        Lifetime economic burden of intimate partner violence among U.S. adults.
        Am J Prev Med. 2018; 55: 433-444
        • Weiser SD
        • Bukusi EA
        • Steinfeld RL
        • et al.
        Shamba maisha: randomized controlled trial of an agricultural and finance intervention to improve HIV health outcomes.
        AIDS. 2015; 29: 1889-1894
        • Cohen CR
        • Steinfeld RL
        • Weke E
        • et al.
        Shamba Maisha: pilot agricultural intervention for food security and HIV health outcomes in Kenya: design, methods, baseline results and process evaluation of a cluster-randomized controlled trial.
        Springerplus. 2015; 4: 122
        • Garcia-Moreno C
        • Jansen HA
        • Ellsberg M
        • Heise L
        • Watts CH
        Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence.
        Lancet. 2006; 368: 1260-1269
        • Coates J
        • Swindale A
        • Bilinsky P
        Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide.
        Food and Nutrition Technical Assistance Project, Academy for Educational Development, Washington, DC2006
        • Rutstein SO
        • Johnson K
        DHS Comperative reports no. 6. The DHS wealth index.
        ORC Macro, Calverton, MDPublished August 2004 (Accessed February 3, 2020)
        • Fulu E
        • Jewkes R
        • Roselli T
        • Garcia-Moreno C
        UN Multi-country Cross-sectional Study on Men and Violence research team. Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN Multi-Country Cross-sectional Study on Men and Violence in Asia and the Pacific.
        Lancet Glob Health. 2013; 1: e187-e207
        • Costa BM
        • Kaestle CE
        • Walker A
        • et al.
        Longitudinal predictors of domestic violence perpetration and victimization: a systematic review.
        Aggress Violent Behav. 2015; 24: 261-272
        • Gilbert L
        • Michalopoulos L
        • Ma X
        • et al.
        How do risk environment factors influence perpetration of partner violence among male migrant and non-migrant market workers in Central Asia? [published correction appears in J Urban Health. 2019;96(1):96].
        J Urban Health. 2019; 96: 83-95
        • Field S
        • Onah M
        • van Heyningen T
        • Honikman S
        Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study.
        BMC Womens Health. 2018; 18: 119
        • Gibbs A
        • Jewkes R
        • Willan S
        • Washington L
        Associations between poverty, mental health and substance use, gender power, and intimate partner violence amongst young (18-30) women and men in urban informal settlements in South Africa: a cross-sectional study and structural equation model.
        PLoS One. 2018; 13e0204956
        • Swahn MH
        • Dill LJ
        • Palmier JB
        • Kasirye R
        Girls and young women living in the slums of Kampala: prevalence and correlates of physical and sexual violence victimization.
        SAGE Open. 2015; 5: 1-8
        • Willie TC
        • Kershaw TS
        • Callands TA
        Examining relationships of intimate partner violence and food insecurity with HIV-related risk factors among young pregnant Liberian women.
        AIDS Care. 2018; 30: 1156-1160
        • Kabwama SN
        • Bukenya J
        • Matovu JKB
        • et al.
        Intimate partner violence among HIV positive women in care - results from a national survey, Uganda 2016.
        BMC Womens Health. 2019; 19: 130
        • Hershow RB
        • Ha TV
        • Sripaipan T
        • et al.
        Perpetration of intimate partner violence among men living with HIV in Northern Vietnam.
        AIDS Behav. 2020; 24: 2555-2571
        • Courtenay WH
        Constructions of masculinity and their influence on men's well-being: a theory of gender and health.
        Soc Sci Med. 2000; 50: 1385-1401
        • Follingstad DR
        • Bush HM.
        Measurement of intimate partner violence: a model for developing the gold standard.
        Psychol Violence. 2014; 4: 369-383
        • Leddy AM
        • Weiss E
        • Yam E
        • Pulerwitz J
        Gender-based violence and engagement in biomedical HIV prevention, care and treatment: a scoping review.
        BMC Public Health. 2019; 19: 897