This report published in PLOS medicine states that both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behaviour has not been systematically investigated. The authors tested the hypothesis that food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland.

Food insufficiency was reported by a third of women and a quarter of men. Among 1,050 women in both countries, after controlling various characteristics, food insufficiency was associated with inconsistent condom use with a nonprimary partner , sex exchange, intergenerational sexual relationships , and lack of control in sexual relationships. Associations between food insufficiency and risky sex were much attenuated among men. The report concludes that food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programmes in conjunction with efforts to enhance women’s legal and social rights may play an important role in decreasing HIV transmission risk for women.