Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the US

• Type of Material: Article
• Authors: Amy A. Conroy, University of California San Francisco; Mardge H. Cohen, Stroger Hospital; Edward A. Frongillo, University of South Carolina; Alexander C. Tsai, Massachusetts General Hospital; Tracey E. Wilson, Suny Downstate Medical Center; Eryka L. Wentz, Johns Hopkins University; Adaora A. Adimora, University of North Carolina; Daniel Merenstein, Georgetown University; Ighovwerha Ofotokun, Emory University; Lisa Metsch, Columbia University; Mirjam-Colette Kempf, University of Alabama; Adebola Adedimeji, Albert Einstein College of Medicine; Janet M. Turan, University of Alabama; Phyllis C. Tien, University of California San Francisco; Sheri D. Weiser, University of California San Francisco
• Language: English
• Date: 2019-03-06
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2019 Conroy et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0213365
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 14
• Issue: 3
• Start Page: e0213365
• End Page: e0213365
• Grant/Funding Information: This study was funded by a Women's Interagency HIV Study (WIHS) sub-study grant from the National Institute of Mental Health, R01MH095683 (Weiser).; WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA).; Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women's Health.; Additional salary support was provided by K01MH107331 (Conroy) and K23MH096620 (Tsai).; WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women's HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; U01-HD-032632 (WIHS I - WIHS IV).; The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH).
• Keywords: Science & Technology; PUBLIC-HEALTH; TRANSACTIONAL SEX; MENTAL-HEALTH; ASSOCIATION; Science & Technology - Other Topics; CAPE-TOWN; SECURITY; INTIMATE PARTNER VIOLENCE; DOMESTIC VIOLENCE; Multidisciplinary Sciences; PREVALENCE; HIV/AIDS
• Research Categories: Health Sciences, Public Health; Sociology, Public and Social Welfare; Psychology, General

Abstract

Background Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women’s Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV. Methods Study participants completed six assessments from 2013–16 on food insecurity (operatio-nalized as marginal, low, and very low food security) and violence (sexual or physical, and psychological). We used multi-level logistic regression, controlling for visits (level 1) nested within individuals (level 2), to estimate the association of experiencing violence. Results Among 2,343 women (8,528 visits), we found that victims of sexual or physical violence (odds ratio = 3.10; 95% confidence interval: 1.88, 5.19) and psychological violence (odds ratio = 3.00; 95% confidence interval: 1.67, 5.50) were more likely to report very low food security. The odds of experiencing violence were higher for women with very low food security at both the current and previous visit as compared to only the current visit. HIV status did not modify these associations. Conclusions Food insecurity was strongly associated with violence, and women exposed to persistent food insecurity were even more likely to experience violence. Food programs and policy must consider persistent exposure to food insecurity, and interpersonal harms faced by food insecure women, such as violence.