Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the US
Food insecurity and violence in a prospective cohort of women at risk for or living with HIV in the US
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DOI：
10.1371/journal.pone.0213365
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发表时间：
2019-03-06
期刊：
影响因子：
3.7
通讯作者：
Weiser, Sheri D.
中科院分区：
文献类型：
--
作者：
Conroy, Amy A.;Cohen, Mardge H.;Weiser, Sheri D.
背景食品不安全和暴力是美国妇女面临的两个主要公共卫生问题。粮食不安全和暴力之间的联系几乎没有受到关注，特别是在事件的时间顺序方面。本研究使用妇女机构间人类免疫缺陷病毒研究的数据，在一组感染艾滋病毒或携带艾滋病毒的高危妇女中调查粮食不安全与暴力的纵向联系。方法研究参与者从2013-16年完成了关于粮食不安全(操作为边缘、低和极低的粮食安全)和暴力(性或身体上的和心理上的)的六项评估。结果在2,343名女性(8,528次访问)中，我们发现性暴力或身体暴力(优势比=3.10；95%可信区间：1.88，5.19)和心理暴力(优势比=3.00；95%可信区间：1.67，5.50)的受害者更有可能报告食品安全水平很低。与只有这次访问相比，粮食保障水平很低的妇女在本次和上次访问中遭受暴力的几率更高。结论食物不安全与暴力密切相关，处于持续食物不安全状态的妇女更有可能遭受暴力。粮食方案和政策必须考虑持续暴露于粮食不安全，以及粮食不安全妇女面临的人际伤害，如暴力。
BackgroundFood 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.MethodsStudy participants completed six assessments from 2013-16 on food insecurity (operationalized 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.ResultsAmong 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.ConclusionsFood 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.