Food Insecurity and Sexual Risk Taking Among Young Filipinos

Background and Purpose: Food insecurity and high-risk sexual behaviors are major global social and health issues. Prior studies have shown that food insecurity is associated with sexual risk taking (Weiser et al., 2007; Tsai et al., 2012), which in turn, heightens risk of sexual victimization and acquisition of sexually transmitted infections, including HIV. Food-insecure individuals engage in high-risk sexual behaviors as a way to obtain or access food. Inadequate access to food has been shown to be associated with inconsistent condom use, sex exchange, and lack of control in sexual relationships. However, little is known whether food insecurity contributes to sexual risk taking among youth. This study examines the association between food insecurity and sexual risk taking among young Filipinos. 

Methods: This study used the 2005 survey of the Cebu Longitudinal Health and Nutrition Study. 1,112 Filipino youth were included in the study. Sexual risk-taking outcomes included (a) sex exchange, defined as ever having been paid to have sex with someone else; (b) forced sex, defined as ever having sex against respondent’s will; and (c) multiple sexual partners; defined as number of sexual partners since respondent began having sex. The main explanatory variable of interest was food insecurity measured by asking respondents whether (1) they had skipped a meal in the past 12 months and (2) the frequency of skipped meals in the past 12 months. Multivariate linear and logistic regressions were conducted to examine association between food insecurity and sexual risk taking.

Results: Average age of youth was 21 years. Twelve percent of youth reported skipping meals in the last 12 months. Ten percent of youth reported engaging in sex exchange, 22% reported having had sex against their will, and 42% had at least two or more sexual partners. Food insecurity was associated with higher odds of forced sex. Youth who reported skipping meals in the past year were 72% more likely than their peers who did not skip a meal to have had sex against their will. Further, youth who skipped meals more than once a month were 265% more likely than their peers who skipped a meal once a month or less to have had sex against their will. However, food insecurity was not associated with sex exchange and having multiple sexual partners.

Conclusions and Implications: Results suggest that food insecurity is associated with sexual risk taking, particularly having sex against will. Youth who have sex against their will may also lack ability to negotiate safer sexual practices, for example condom use, with their partners. Having sex against will and other risky sexual behaviors, in turn, may increase risk of HIV transmission, sexual victimization, and other adverse sexual health outcomes among youth. Given that young Filipinos ages 20-29 account for more than half of reported HIV cases and the Philippines is one of only nine countries where HIV incidence has increased more than 25% in the last 10 years, interventions targeting food insecurity among youth may have beneficial effects on HIV prevention in the country.