ABSTRACT
Since the early stages of the HIV epidemic, social science researchers have described how unequal gender relations and gendered structural constraints facilitate the spread of HIV among women [1], particularly among women in sub-Saharan Africa [2]–[5]. A series of newer studies have highlighted food insecurity as a central variable shaping women’s risks of HIV exposure. Although women often occupy a primary role in household food production in sub-Saharan Africa, gender bias in the distribution of resources within the household places them at elevated risk for food insecurity compared with men [6],[7]. Qualitative research suggests that inadequate or uncertain access to food exerts an undue influence on women’s decisions to engage in transactional sex or unprotected sex [8] or enter commercial sex work [9]. In a populationbased study of women in Botswana and Swaziland, food insufficiency was associated with risky sexual behaviors including inconsistent condom use, even
after statistical adjustment for education and household income [10],[11], and subsequent studies have replicated these findings in different settings in subSaharan Africa [12],[13].
