Food insecurity, sexual risk behavior, and adherence to antiretroviral therapy among women living with HIV: A systematic review

ABSTRACT

Gender inequalities shape the experience of food insecurity among women living with HIV (WLHIV). We systematically reviewed the impact of food insecurity on sexual risk behaviors and antiretroviral therapy (ART) adherence among WLHIV. We included qualitative or quantitative peer-reviewed articles, extracted data in duplicate, and assessed rigor. Seven studies, from sub-Saharan Africa, North America, and Europe, met inclusion criteria. Food insecurity was associated with increased sexual risk through transactional sex and inability to negotiate safer sex. Hunger and food insecurity were barriers to ART initiation/adherence. Multidimensional programming and policies should simultaneously address poverty, gender inequality, food insecurity, and HIV.

Acknowledgments

The authors would like to acknowledge the members of the WHO guideline development group who provided input to this review.

Funding

This review was funded by the World Health Organization, Department of Reproductive Health and Research.