Exploring the Relationships Among Food Insecurity, Alcohol Use, and Sexual Risk Taking Among Men and Women Living in South African Townships
Exploring the Relationships Among Food Insecurity, Alcohol Use, and Sexual Risk Taking Among Men and Women Living in South African Townships
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DOI：
10.1007/s10935-014-0346-3
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发表时间：
2014-08-01
影响因子：
1.7
通讯作者：
Kalichman, Seth C.
中科院分区：
文献类型：
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作者：
Eaton, Lisa A.;Cain, Demetria N.;Kalichman, Seth C.
南非的乡镇是世界上艾滋病毒感染率最高的地区之一。在了解我国艾滋病毒高传播率方面进行的大量研究已经确定，饮酒是推动艾滋病毒流行的一个关键因素。虽然酒精使用和性冒险之间的关系有充分的记录，但对于其他因素，如粮食不安全，在理解酒精在性冒险中的作用方面可能是多么重要，我们所知甚少。此外，先前的研究强调了饮酒和性冒险的模式如何因性别而异。我们研究了食物不安全与饮酒和性冒险之间的关系。我们对居住在南非开普敦外四个相邻的非洲黑人城镇内的男性（n = 1137）和女性（n = 458）进行了匿名社区调查。在多元线性回归中，我们发现食品不安全与男性性伴侣数量较多以及仅在女性中有安全套保护的性行为有关。然而，这些关系完全由女性饮酒介导。在男性中，我们发现粮食不安全与无保护的性行为呈负相关；也就是说，有更多食物保障的男性报告了更多无保护的性行为。与在女性中发现的结果不同，这种关系不是由饮酒介导的。粮食不安全似乎是了解与性别和酒精使用有关的性冒险模式的一个重要因素，并可能成为减少艾滋病毒传播率的一个重要干预点。
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.