ArticlePloS one2021
Intersections of food insecurity, violence, poor mental health and substance use among US women living with and at risk for HIV: Evidence of a syndemic in need of attention.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic review of qualitative research on HIV and food insecurity in high-income countries.AIDS (London, England) · 2026Pooled it
- Food insecurity and gender-based violence against women during the COVID-19 pandemic: a systematic review.BMC public health · 2026Pooled it
- The Characteristics and HIV-Related Outcomes of People Living with Co-occurring HIV and Mental Health Conditions in the United States: A Systematic Review of Literature from 2016 to 2021.AIDS and behavior · 2024Pooled it
- The impact of intimate partner violence on PrEP adherence among U.S. Cisgender women at risk for HIV.BMC public health · 2024Trial
- High Motivation but Low Access to PrEP: Social Determinants Undermine HIV Prevention Among Sexual and Gender Minority People Who Use Methamphetamine.AIDS and behavior · 2026Article
- The Syndemic Effects of Food Insecurity, Depression, and Gender-Based Violence on HIV Treatment Outcomes Among People with HIV in Zimbabwe.AIDS and behavior · 2026Observational
- Monocyte epigenetic age acceleration is linked to non-somatic depressive symptoms in women with and without HIV.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Complexity of Adherence Challenges: Understanding Syndemic Factors Affecting HIV Treatment Adherence During Treatment Initiation in Cape Town, South Africa.AIDS and behavior · 2026Article
- Syndemic convergence of mpox and HIV crisis in the Philippines: implications for integrated and responsive public health action.International journal for equity in health · 2026Article
- The association between social drivers of health, HIV status and physical activity with perceived stress in U.S. women with or without HIV.BMC public health · 2025Article
- Probable Depression Is Associated with Lower BMI Among Women on ART in Kinshasa, the Democratic Republic of Congo: A Cross-Sectional Study.Nutrients · 2025Article
- Exploring Allostatic Load as an Objective Measure of Stress Among U.S. Women With and Without HIV: A Pilot Study.Journal of women's health (2002) · 2025Article
- Exploring HIV Risk Among Sexual Minority Women by Identity and Behavior in a Population-Based Sample of Low-Income Heterosexually Active Women.LGBT health · 2025Article
- Heterogeneous depressive symptom trajectories among women with type 2 diabetes: findings from the Women's Interagency HIV Study.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- Associations of Unmet Food and Housing Needs with Mental Health and Overall Perceived Health Among Women with HIV: Is There a Moderating Effect of Social Support?Women's health reports (New Rochelle, N.Y.) · 2025Article
- Social Vulnerability and Mental Health Among People with HIV and Substance Use: The Role of Race.AIDS and behavior · 2024Article
- Expert Consensus Statement on an Updated Definition of Unintended Weight Loss Among Persons With Human Immunodeficiency Virus in the Modern Treatment Era.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Review
- Mental health service use and shortages among a cohort of women living with HIV in Canada.BMC health services research · 2024Article
- Bringing together the pieces: the need for holistic care for women with HIV.Journal of the International AIDS Society · 2024Article
- Exploring the Impact of an Integrated Trauma-Informed HIV and Vocational Intervention for Black/African American Women Living with HIV.International journal of environmental research and public health · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundFood insecurity and intimate partner violence (IPV) are associated with suboptimal HIV prevention and treatment outcomes, yet limited research has explored how food insecurity and IPV intersect to influence HIV-related behaviors. To fill this gap, we conducted a qualitative study with women living with or at risk for HIV in the United States.
methodsWe conducted 24 in-depth interviews with women enrolled in the San Francisco and Atlanta sites of the Women's Interagency HIV study (WIHS). Participants were purposively sampled so half were living with HIV and all reported food insecurity and IPV in the past year. Semi-structured interviews explored experiences with food insecurity and IPV, how these experiences might be related and influence HIV risk and treatment behaviors. Analysis was guided by an inductive-deductive approach.
resultsA predominant theme centered on how food insecurity and IPV co-occur with poor mental health and substance use to influence HIV-related behaviors. Women described how intersecting experiences of food insecurity and IPV negatively affected their mental health, with many indicating using substances to "feel no pain". Substance use, in turn, was described to perpetuate food insecurity, IPV, and poor mental health in a vicious cycle, ultimately facilitating HIV risk behaviors and preventing HIV treatment adherence.
conclusionsFood insecurity, IPV, poor mental health and substance use intersect and negatively influence HIV prevention and treatment behaviors. Findings offer preliminary evidence of a syndemic that goes beyond the more widely studied "SAVA" (substance use, AIDS, and violence) syndemic, drawing attention to additional constructs of mental health and food insecurity. Quantitative research must further characterize the extent and size of this syndemic. Policies that address the social and structural drivers of this syndemic, including multi-level and trauma-informed approaches, should be implemented and evaluated to assess their impact on this syndemic and its negative health effects.
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