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Food Insufficiency is Associated with High Risk Sexual Behavior among Women in Botswana and Swaziland Presented by: Nthabiseng Phaladze, PhD and Sheri Weiser, MD, MPH Authors: Sheri Weiser, Karen Leiter, David Bangsberg, Lisa Butler, Fiona Percy, Zakhe Hlanze, Nthabiseng Phaladze, Vincent Iacopino and Michele Heisler PLoS Medicine . October 2007; 4(10); e-260 October 22, 2007 Funded by: Physicians for Human Rights and NIH
HIV and Food Insufficiency ,[object Object],[object Object],[object Object],[object Object]
Food Insufficiency and HIV Transmission Risk ,[object Object],[object Object],[object Object]
Aims for Population-based Study in Botswana/Swaziland ,[object Object],[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods cont. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],**UNAIDS HIV/AIDS Prevention Indicator Survey; May 2000 *Using the Huber/White heteroscedastic estimator of the variance/covariance
Sample ,[object Object],[object Object],[object Object]
Participant Characteristics * Denotes statistically significant differences between men and women 52%* 47%* Education >=HS 10%* 2%* Paying for sex 2%* 26%* Lack of control in sex 15%  17%  Intergenerational sex 1%* 5%* Exchanging sex 11%* 8%* Unprotected sex 30%*  17%*  Problem drinking 38%  32%  Rural residence 22%* 32%* Food insufficiency Men  (n=999) Women  (n=1050)
Adjusted Correlates of Unprotected Sex with Non-monogamous Partner* *Model also controlled for age and  living with sexual partner 1.1 (1.1-1.2) 1.7 (1.3-2.4) Food insufficiency 2.1 (1.4-3.2) 4.4 (1.7-11.0) Problem drinking 1.0 (0.8-1.2) 0.6 (0.5-0.6) Correct HIV knowledge 1.1 (0.3-3.7) 0.5 (0.4-0.5) Rural residence 0.8 (0.4-1.6) 1.1 (0.8-1.6) Married (compared with single) 0.8 (0.7-0.8) 1.2 (0.6-2.4) Income >= Median 0.9 (0.6-1.4) 0.7 (0.6-0.9) Education >= HS Men AOR (95% CI) Women AOR (95% CI)
Adjusted Correlates of Sex Exchange* *Model also controlled for age and living with sexual partner 1.1 (0.5-2.3) 1.8 (1.7-1.9) Food insufficiency 3.2 (1.9-5.5) 12.5 (8.5-18.3) Problem drinking 1.5 (0.3-6.6) 0.7 (0.6-0.8) Correct HIV knowledge 1.1 (0.6-2.2) 1.7 (1.0-3.1) Rural residence 0.2 (0.1-0.6) 0.8 (0.6-1.0) Married (compared with single) 1.9 (1.6-2.4) 0.9 (0.5-1.6) Income >= Median 1.1 (0.8-1.6) 0.7 (0.4-1.5) Education >= HS Men (Paying for sex) AOR (95% CI) Women  (Exchanging sex) AOR (95% CI)
Adjusted Correlates of Intergenerational Sex* *Model also controlled for age and living with sexual partner 1.3 (0.6-2.7) 1.5 (1.1-2.1) Food insufficiency 1.0 (0.5-2.1) 2.1 (1.6-2.8) Problem drinking 1.4 (1.0-2.1) 1.3 (0.9-1.8) Correct HIV knowledge 1.1 (0.7-1.3) 1.2 (0.8-1.7) Rural residence 0.3 (0.1-1.3) 1.1 (0.5-2.1) Married (compared with single) 1.1 (0.4-3.1) 0.9 (0.7-1.2) Income >= Median 0.8 (0.4-1.8) 0.8 (0.5-1.3) Education >= HS Men AOR (95% CI) Women  AOR (95% CI)
Adjusted Correlates of Lack of Control in Sexual Relations for Women* *Model also controlled for age and living with sexual partner 1.2 - 2.3 1.7 Food insufficiency 0.9 - 2.0 1.3 Problem drinking 1.1 - 1.7 1.4 Correct HIV knowledge 0.8 - 1.7 1.2 Rural residence 2.0 - 2.5 2.3 Married (compared with single) 0.8 - 1.1 0.9 Income >= Median 0.4 - 0.4 0.4 Education >= HS 95% CI AOR
Limitations ,[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]
Implications  ,[object Object],[object Object]
Acknowledgements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Food Insufficiency is Associated with High Risk Sexual Behavior among Women in Botswana and Swaziland

  • 1. Food Insufficiency is Associated with High Risk Sexual Behavior among Women in Botswana and Swaziland Presented by: Nthabiseng Phaladze, PhD and Sheri Weiser, MD, MPH Authors: Sheri Weiser, Karen Leiter, David Bangsberg, Lisa Butler, Fiona Percy, Zakhe Hlanze, Nthabiseng Phaladze, Vincent Iacopino and Michele Heisler PLoS Medicine . October 2007; 4(10); e-260 October 22, 2007 Funded by: Physicians for Human Rights and NIH
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  • 9. Participant Characteristics * Denotes statistically significant differences between men and women 52%* 47%* Education >=HS 10%* 2%* Paying for sex 2%* 26%* Lack of control in sex 15%  17%  Intergenerational sex 1%* 5%* Exchanging sex 11%* 8%* Unprotected sex 30%*  17%*  Problem drinking 38%  32%  Rural residence 22%* 32%* Food insufficiency Men (n=999) Women (n=1050)
  • 10. Adjusted Correlates of Unprotected Sex with Non-monogamous Partner* *Model also controlled for age and living with sexual partner 1.1 (1.1-1.2) 1.7 (1.3-2.4) Food insufficiency 2.1 (1.4-3.2) 4.4 (1.7-11.0) Problem drinking 1.0 (0.8-1.2) 0.6 (0.5-0.6) Correct HIV knowledge 1.1 (0.3-3.7) 0.5 (0.4-0.5) Rural residence 0.8 (0.4-1.6) 1.1 (0.8-1.6) Married (compared with single) 0.8 (0.7-0.8) 1.2 (0.6-2.4) Income >= Median 0.9 (0.6-1.4) 0.7 (0.6-0.9) Education >= HS Men AOR (95% CI) Women AOR (95% CI)
  • 11. Adjusted Correlates of Sex Exchange* *Model also controlled for age and living with sexual partner 1.1 (0.5-2.3) 1.8 (1.7-1.9) Food insufficiency 3.2 (1.9-5.5) 12.5 (8.5-18.3) Problem drinking 1.5 (0.3-6.6) 0.7 (0.6-0.8) Correct HIV knowledge 1.1 (0.6-2.2) 1.7 (1.0-3.1) Rural residence 0.2 (0.1-0.6) 0.8 (0.6-1.0) Married (compared with single) 1.9 (1.6-2.4) 0.9 (0.5-1.6) Income >= Median 1.1 (0.8-1.6) 0.7 (0.4-1.5) Education >= HS Men (Paying for sex) AOR (95% CI) Women (Exchanging sex) AOR (95% CI)
  • 12. Adjusted Correlates of Intergenerational Sex* *Model also controlled for age and living with sexual partner 1.3 (0.6-2.7) 1.5 (1.1-2.1) Food insufficiency 1.0 (0.5-2.1) 2.1 (1.6-2.8) Problem drinking 1.4 (1.0-2.1) 1.3 (0.9-1.8) Correct HIV knowledge 1.1 (0.7-1.3) 1.2 (0.8-1.7) Rural residence 0.3 (0.1-1.3) 1.1 (0.5-2.1) Married (compared with single) 1.1 (0.4-3.1) 0.9 (0.7-1.2) Income >= Median 0.8 (0.4-1.8) 0.8 (0.5-1.3) Education >= HS Men AOR (95% CI) Women AOR (95% CI)
  • 13. Adjusted Correlates of Lack of Control in Sexual Relations for Women* *Model also controlled for age and living with sexual partner 1.2 - 2.3 1.7 Food insufficiency 0.9 - 2.0 1.3 Problem drinking 1.1 - 1.7 1.4 Correct HIV knowledge 0.8 - 1.7 1.2 Rural residence 2.0 - 2.5 2.3 Married (compared with single) 0.8 - 1.1 0.9 Income >= Median 0.4 - 0.4 0.4 Education >= HS 95% CI AOR
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