Poverty, Food Insufficiency and HIV Infection and Sexual Behaviour among Young Rural Zimbabwean Women

Abstract

BackgroundDespite a recent decline, Zimbabwe still has the fifth highest adult HIV prevalence in the world at 14.7%; 56% of the population are currently living in extreme poverty.DesignCross-sectional population-based survey of 18–22 year olds, conducted in 30 communities in south-eastern Zimbabwe in 2007.ObjectiveTo examine whether the risk of HIV infection among young rural Zimbabwean women is associated with socio-economic position and whether different socio-economic domains, including food sufficiency, might be associated with HIV risk in different ways.MethodsEligible participants completed a structured questionnaire and provided a finger-prick blood sample tested for antibodies to HIV and HSV-2. The relationship between poverty and HIV was explored for three socio-economic domains: ability to afford essential items; asset wealth; food sufficiency. Analyses were performed to examine whether these domains were associated with HIV infection or risk factors for infection among young women, and to explore which factors might mediate the relationship between poverty and HIV.Results2593 eligible females participated in the survey and were included in the analyses. Overall HIV prevalence among these young females was 7.7% (95% CI: 6.7–8.7); HSV-2 prevalence was 11.2% (95% CI: 9.9–12.4). Lower socio-economic position was associated with lower educational attainment, earlier marriage, increased risk of depression and anxiety disorders and increased reporting of higher risk sexual behaviours such as earlier sexual debut, more and older sexual partners and transactional sex. Young women reporting insufficient food were at increased risk of HIV infection and HSV-2.ConclusionsThis study provides evidence from Zimbabwe that among young poor women, economic need and food insufficiency are associated with the adoption of unsafe behaviours. Targeted structural interventions that aim to tackle social and economic constraints including insufficient food should be developed and evaluated alongside behaviour and biomedical interventions, as a component of HIV prevention programming and policy.

Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

“…Third, between half and two-thirds of adolescents reported having an older sexual partner during first sex, which is linked to reduced condom use in the general adolescent population [68]. Fourth, one in five participants reported engaging in transactional sex or having sex for money or goods–a sexual practice associated with unprotected sex [82], a result that was consistent across multiple studies [63,73,75]. HIV-positive adolescent girls reported a higher prevalence of transactional sex, having older sexual partners, and unprotected sex, though adolescent boys were more likely to report early sexual activity and multiple sexual partners.…”

“…Sixth, studies testing for biomarkers of HSV-2 and HPV found 50% and 88% infection rates in HIV-positive adolescents, respectively [57,73]. This suggests high levels of unprotected sex and higher risk for co-infection with other sexually transmitted infections.…”

Enriched cultures of lactic acid bacteria from selected Zimbabwean fermented food and medicinal products with potential as therapy or prophylaxis against yeast infections

“…Probiotic microorganisms have been shown to have prophylactic and therapeutic effects against gastrointestinal diseases, particularly diarrhoea. With a high HIV prevalence rate (15.2% in the 15-49 years age group; 2015 data) [3], erratic outbreaks of diarrhoeal diseases [4,5] and high prevalence of sexually transmitted infections [6] that collectively co-occur with poverty [7], the use of complementary diets and medicines has remained central to maintaining wellness and treatment of diarrhoea among many residents of Zimbabwe.…”

Consistent Provisions Mitigate Exposure to Sexual Risk and HIV Among Young Adolescents in South Africa

“…Evidence examining exposure to sexual risk has largely focused on 15-to 24-year-old adolescent girls and young women, particularly given the strong association between sexual risk exposure and heterosexual HIV infection in this population in sub-Saharan Africa [7][8][9]. Early sexual debut, sex in exchange for goods or money, and age-disparate relationships among young women and older sexual partners also contribute to high HIV infection risk [10][11][12][13][14][15][16], including unintended pregnancies [17].…”