Exploring the Relationships Among Food Insecurity, Alcohol Use, and Sexual Risk Taking Among Men and Women Living in South African Townships

• Published in: The Journal of primary prevention 2014-08, Vol.35 (4), p.255-265
• Main Authors: Eaton, Lisa A., Cain, Demetria N., Pitpitan, Eileen V., Carey, Kate B., Carey, Michael P., Mehlomakulu, Vuyelwa, Simbayi, Leickness C., Mwaba, Kelvin, Kalichman, Seth C.
• Format: Article
• Language: English
• Subjects: Acquired Immune Deficiency Syndrome; Addictive behaviors; Adult; Adult and adolescent clinical studies; African Continental Ancestry Group - psychology; AIDS; Alcohol Abuse; Alcohol Drinking - ethnology; Alcohol Drinking - psychology; Alcohol Education; Alcohol use; Alcoholism; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Cape Town, South Africa; Community and Environmental Psychology; Community Surveys; Disease transmission; Drinking; Epidemics; Female; Females; Food Security; Food Supply; Gender; Government School Relationship; Health Psychology; HIV; Human immunodeficiency virus; Humans; Infections; Intervention; Male; Males; Medical sciences; Medicine; Medicine & Public Health; Municipalities; Nutrition; Original Paper; Prevention; Prevention and actions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex; Sex Factors; Sexual Behavior; Socioeconomic Factors; South Africa; Toxicology; Unsafe Sex - ethnology; Unsafe Sex - psychology; Unsafe Sex - statistics & numerical data; Women
• ISSN: 0278-095X; 1573-6547
• DOI: 10.1007/s10935-014-0346-3

South African townships have among the highest rates of HIV infection in the world. Considerable research on understanding the high rates of HIV transmission in this country has identified alcohol use as a critical factor in driving the HIV epidemic. Although the relationship between alcohol use and sexual risk-taking is well documented, less is known about how other factors, such as food insecurity, might be important in understanding alcohol’s role in sexual risk-taking. Furthermore, prior research has highlighted how patterns of alcohol use and sexual risk-taking tend to vary by gender. We examined how food insecurity is related to both alcohol use and sexual risk-taking. We administered anonymous community surveys to men ( n  = 1,137) and women ( n  = 458) residing within four contiguous Black African townships outside of Cape Town, South Africa. In multivariate linear regression, we found that food insecurity was related to having higher numbers of male sex partners and condom-protected sex acts among women only. These relationships, however, were fully mediated by women’s alcohol use. Among men, we found that food insecurity was negatively related to unprotected sex; that is, men with greater food security reported more unprotected sex acts. Unlike the results found among women, this relationship was not mediated by alcohol use. Food insecurity appears to be an important factor in understanding patterns of sexual risk-taking in regards to gender and alcohol use, and may serve as an important point of intervention for reducing HIV transmission rates.