Food Insufficiency, Substance Use, and Sexual Risks for HIV/AIDS in Informal Drinking Establishments, Cape Town, South Africa
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HIV/AIDS is concentrated in impoverished communities. Two critical aspects of poverty are food insufficiency and substance abuse, and both are associated with sexual risks for HIV/AIDS in southern Africa. The current study is the first to examine both hunger and substance use in relation to sexual risks for HIV infection in South African alcohol serving establishments. Anonymous venue-based intercept surveys were completed by men (n = 388) and women (n = 407) patrons of six informal drinking places (e.g., shebeens) in Cape Town, South Africa. Food insufficiency and its more extreme form hunger were common in the sample, with 24 % of men and 53 % of women experiencing hunger in the previous 4 months. Multiple regression analyses showed that quantity of alcohol use was related to higher rates of unprotected sex for men and women. Trading sex to meet survival needs was related to food insufficiency and methamphetamine use among men but not women. Food insufficiency and substance use may both contribute to HIV risks in South African shebeens. However, the influence of hunger and substance use on sexual risks varies for men and women. Interventions to reduce HIV transmission risks may be bolstered by reducing both food insufficiency and substance use.
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Studies have consistently linked food insecurity to risky sexual behavior among women in resource-limited settings, including sub-Saharan Africa.
“Other studies have documented a consistent association between food insecurity and women’s risky sexual behavior in resource-limited settings including those in sub-Saharan Africa [30–34].”
From Relationship power and sexual violence among HIV-positive women in rural Uganda (2016) · cites this paper as [32]
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- Authors
- Kalichman, S. C., Watt, M., Sikkema, K., Skinner, D., & Pieterse, D.
- Affiliations
- University of Connecticut (US)
- Duke University (US)
- Stellenbosch University (ZA)
- Corresponding author
- Kalichman, Seth C.
- Venue
- Journal of Urban Health
- Published
- 2012-06-06
- Volume
- 89
- Issue
- 6
- Pages
- 939-951
- ISSN
- 0028-7091 (ISSN-L)
- 1099-3460
- 1468-2869
- PMC
- PMC3531356
- OpenAlex
- W2035996930
- Cited by
- 23
- References
- 34
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 4
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Urban Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA018074)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- food insufficiency, hunger, substance use, HIV/AIDS risk, unprotected sex, shebeens, methamphetamine, poverty, gender differences, alcohol consumption, Cape Town
- MeSH terms
- Adolescent, Adult, Aged, Alcohol Drinking, Female, Food Supply, Health Surveys, Humans, Hunger, Male, Middle Aged, Regression Analysis, Risk Factors, Sexual Behavior, South Africa, HIV Infections, Prevalence, Substance-Related Disorders, Unsafe Sex, Young Adult
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