title: Food Insecurity Increases HIV Risk Among Young Sex Workers in Metro Vancouver, Canada.
abstract: This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010-2013). We examined the independent relationship between YSWs' food insecurity and being pressured into sex without a condom by clients ("client condom refusal"). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23-3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs' particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity.
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.|YouthCO HIV & Hep C Society, 205-568 Seymour St, Vancouver, V6B 3J5, Canada.
authors.forename: Daniella
authors.initials: D
authors.lastname: Barreto
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.|Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, V5Z 1M9, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.
authors.forename: Chrissy
authors.initials: C
authors.lastname: Taylor
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.
authors.forename: Sabina
authors.initials: S
authors.lastname: Dobrer
authors.affiliation: YouthCO HIV & Hep C Society, 205-568 Seymour St, Vancouver, V6B 3J5, Canada.
authors.forename: Jessica St
authors.initials: JS
authors.lastname: Jean
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.|Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, V5A 1S6, Canada.
authors.forename: Shira M
authors.initials: SM
authors.lastname: Goldenberg
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada.|Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, V5Z 1M9, Canada.
authors.forename: Putu
authors.initials: P
authors.lastname: Duff
authors.affiliation: BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608 - 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada. kdeering@cfenet.ubc.ca.|Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, V5Z 1M9, Canada. kdeering@cfenet.ubc.ca.
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Deering
mesh_terms: D000328:Adult; D001955:British Columbia; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012306:Risk; D060386:Sex Workers / Q000706:statistics & numerical data*; D047568:Unsafe Sex; D055815:Young Adult
keywords: Food insecurity; HIV; Sex work; Youth