Persistent Food Insecurity (PFI), HIV, and Maternal Stress Levels in Peri‐Urban Ghana

Abstract

We examined the associations between HIV, PFI, and the PFI*HIV interaction on maternal stress (N=232). Women recruited prenatally from hospitals offering voluntary counseling and testing (VCT) were followed for 12 months after childbirth. The US Household Food Security Survey Module was applied at 5 time points. Households were classified as PFI (ie. food insecure at each time point) vs. periodically food insecure or persistently food secure. Maternal stress levels were measured with the 4-item Cohen scale. Women were classified as having low or high stress at 12 months postpartum based in reference to the median stress score. Being HIV-positive (AOR=2.30, 95% CI 1.29–4.12) and PFI (AOR=3.55, 95% CI 1.13–11.13) were independently associated with high stress. With HIV status and PFI included in the model, only being HIV-positive was associated with high stress (AOR= 2.03, 95% CI 1.09–3.77). Being both HIV-positive and PFI, vs. not experiencing these 2 conditions, was strongly associated with high stress (AOR=15.35, 95% CI 1.90–124.14). Intervention studies are needed to understand how to reduce stress among HIV-positive women living in PFI households. Funded by NIH/NICHD HDH 43620, NIMH T32MH020031; solely the responsibility of authors.