***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Food insecurity ( FI ) is the lack of physical , social , and economic access to sufficient food for dietary needs and food preferences . We examined the association between FI and women ’s uptake of services to prevent mother-to-child HIV transmission ( MTCT ) in Zimbabwe . Methods We analyzed cross-sectional data collected in 2012 from women living in five of ten provinces . Eligible women were ≥16 years old , biological mothers of infants born 9–18 months before the interview , and were r and omly selected using multi-stage cluster sampling . Women and infants were tested for HIV and interviewed about health service utilization during pregnancy , delivery , and post-partum . We assessed FI in the past four weeks using a subset of questions from the Household Food Insecurity Access Scale and classified women as living in food secure , moderately food insecure , or severely food insecure households . Results The weighted population included 8,790 women . Completion of all key steps in the PMTCT cascade was reported by 49 % , 45 % , and 38 % of women in food secure , moderately food insecure , and severely food insecure households , respectively ( adjusted prevalence ratio ( PRa ) = 0.95 , 95 % confidence interval ( CI ) : 0.90 , 1.00 ( moderate FI vs. food secure ) , PRa = 0.86 , 95 % CI : 0.79 , 0.94 ( severe FI vs. food secure ) ) . Food insecurity was not associated with maternal or infant receipt of ART/ARV prophylaxis . However , in the unadjusted analysis , among HIV-exposed infants , 13.3 % of those born to women who reported severe household food insecurity were HIV-infected compared to 8.2 % of infants whose mothers reported food secure households ( PR = 1.62 , 95 % CI : 1.04 , 2.52 ) . After adjustment for covariates , this association was attenuated ( PRa = 1.42 , 95 % CI : 0.89 , 2.26 ) . There was no association between moderate food insecurity and MTCT in unadjusted or adjusted analyses ( PRa = 0.68 , 95 % CI : 0.43 , 1.08 ) . Conclusions Among women with a recent birth  , food insecurity is inversely associated with service utilization in the PMTCT cascade and severe household food insecurity may be positively associated with MTCT . These preliminary findings support the assessment of FI in antenatal care and integrated food and nutrition programs for pregnant women to improve maternal and child health Objective : Although the physical health benefits of HIV antiretroviral therapy ( ART ) are well documented , the socioeconomic benefits are still being established . Few studies have examined the effects of ART on food insecurity , although studies suggest there may be a benefit via improved health and ability to work . Design : Twelve-month prospect i ve cohort study of 602 treatment-naive patients initiating clinical care in Ug and a. Methods : Longitudinal multivariate logistic regression was used to investigate the effect of ART on food insecurity compared to HIV care without ART . A staged regression approach was used to explore pathways through which ART may affect food insecurity . Results : Food insecurity decreased significantly for both the ART and non-ART groups over time , with the ART group experiencing greater reductions by the end of the study . ART remained a significant predictor of reduction in food insecurity over time after controlling for baseline differences in the regression model ( odds ratio 0.642 ; P < 0.01 ) . Improvements in work and mental health status were identified as potential pathways through which ART may improve food security . Conclusion : Taken together with the well known benefits of food security on ART adherence , treatment retention and clinical outcomes in re source -poor setting s , our results suggest that a positive feedback loop of improved functioning and productivity could result from the interaction between food security and ART . Policymakers could leverage this positive cycle by strengthening mental health support and promoting sustainable food security interventions as part of HIV treatment programs Objective : Despite emerging evidence of a significant adverse relationship between food insecurity and sexual risk-taking , data have been primarily derived from re source -constrained setting s and HIV-negative population s. To our knowledge , this study is the first to longitudinally evaluate the relationship between food insecurity and unprotected sex among HIV-seropositive people who inject drugs [ injection drug users ( IDUs ) ] both on and not on HAART . Design : Longitudinal analyses were restricted to HIV-positive IDUs who completed baseline and at least one follow-up visit in a prospect i ve cohort ( AIDS Care Cohort to evaluate Exposure to Survival Services , 2005–2009 ) . Methods : We constructed a multivariate logistic model using generalized estimating equations ( GEEs ) to assess an independent relationship between severe food insecurity ( e.g. , hunger due to lack of access or means to acquire food ) and unprotected vaginal/anal sex . Results : Among 470 HIV-positive IDUs , the median age was 42 years ( interquartile range 36–47 ) with 61 % men and 39 % women . The prevalence of severe food insecurity was 71 % , with no differences by HAART use . Severe food insecure IDUs were marginally less likely to have a suppressed HIV-1 RNA viral load ( 31 vs. 39 % , P = 0.099 ) . In multivariate GEE analyses , severe food insecurity [ adjusted odds ratio = 2.68 , 95 % confidence interval 1.49–4.82 ] remained independently correlated with unprotected sex among HIV-positive IDUs , controlling for age , sex/gender , married/cohabitating partner , binge drug use , homelessness , and HAART use . Conclusion : These findings highlight a crucial need for structural HIV interventions that incorporate targeted food assistance strategies for IDUs . Given recent evidence of poor virological response among food insecure individuals on HAART , innovative HIV care models should integrate targeted food security programs and early access to HAART Abstract African American women at increased risk of HIV/sexually transmitted infection ( STI ) may engage in risky sex as a coping mechanism for depressed economic conditions . This study examines the association between high-risk sexual behavior and structural determinants of sexual health among a sample of young African American women . 237 young African American women ( 16–19 years old ) from economically disadvantaged neighborhoods in North Carolina were enrolled into a r and omized trial testing the efficacy of an adapted HIV/STI prevention intervention . Logistic regression analyses predicted the likelihood that young women reporting lack of food at home , homelessness and low future prospect s would also report sexual risk behaviors . Young women reporting a lack of food at home ( 22 % ) , homelessness ( 27 % ) , and low perceived education/employment prospect s ( 19 % ) had between 2.2 and 4.7 times the odds as those not reporting these risk factors of reporting multiple sex partners , risky sex partners including older men and partners involved in gangs , substance use prior to sex , and exchange sex . Self-reported structural determinants of sexual health were associated with myriad sexual risk behaviors . Diminished economic conditions among these young women may lead to sexual risk due to hopelessness , the need for survival or other factors BACKGROUND Household food insecurity is positively associated with weight among women . The association between household food insecurity and pregnancy-related  weight gain and complications is not well understood . OBJECTIVE To identify whether an independent association exists between household food insecurity and pregnancy-related complications . DESIGN Data from the Pregnancy , Infection , and Nutrition prospect i ve cohort study were used to assess household food insecurity retrospectively using the US Department of Agriculture 18-item Core Food Security Module among 810 pregnant women with incomes < or = 400 % of the income/poverty ratio , recruited between January 2001 and June 2005 and followed through pregnancy . MAIN OUTCOME MEASURES Self-reported pregravid body mass index , gestational weight gain , second trimester anemia , pregnancy-induced hypertension , and gestational diabetes mellitus . STATISTICAL ANALYSES PERFORMED Multivariate linear , multinomial logistic , and logistic regression analyses . RESULTS Among 810 pregnant women , 76 % were from fully food secure , 14 % were from marginally food secure , and 10 % were from food insecure households . In adjusted models , living in a food insecure household was significantly associated with severe pregravid obesity ( adjusted odds ratio 2.97 , 95 % confidence intervals [ CIs ] 1.44 to 6.14 ) , higher gestational weight gain ( adjusted beta coefficient 1.87 , 95 % CI 0.13 to 3.62 ) , and with a higher adequacy of weight gain ratio ( adjusted beta .27 , 95 % CI 0.07 to 0.50 ) . Marginal food security was significantly associated with gestational diabetes mellitus ( adjusted odds ratio 2.76 , 95 % CI 1.00 to 7.66 ) . CONCLUSIONS This study highlights the possibility that living in a food insecure household during pregnancy may increase risk of greater weight gain and pregnancy complications This paper examines the impact of water fetching  by women and the quality of water during periods of water scarcity on the health of women in the Kumasi metropolitan area . A sample of 210 women drawn using systematic r and om procedure is used for the study . Formal interview is the main instrument used . The survey has established that income , quality of water , hours spent fetching water during scarcity and age are the main factors influencing women 's health in the metropolis during water scarcity . In both the core and periphery , the water-related problem influencing health is hours spent fetching water during scarcity . An empirical model on water needs and women 's health has emerged from the survey . Recommendations have been made on strategies to ensure regular volume of surface water , effective management of scarce water re sources with the participation of women , and ensuring gender equity in domestic services OBJECTIVE : To estimate whether there is an association between chronic psychosocial stress and low birth weight neonates in low-income women . METHODS : Between 1999 and 2004 , a r and om sample of women receiving welfare in nine Illinois counties was selected . The women were then interviewed annually . Women who delivered during this period were identified . Self-reported stress that occurred in temporal proximity to the delivery was assessed by 1 ) external stressors , 2 ) enhancers of stress , 3 ) buffers against stress , and 4 ) perceived stress and was compared between women who delivered low birth weight neonates and women who delivered normal birth weight neonates . RESULTS : Of the 1,363 women in the study , 294 women ( 21.6 % ) became pregnant and delivered during the study period . Of the 294 deliveries , 39 ( 13.3 % ) were low birth weight . The only demographic factor associated with a low birth weight delivery was increasing maternal age . However , multiple psychosocial factors , including food insecurity ( odds ratio [ OR ] 3.2 , 95 % confidence interval [ CI ] 1.4–7.2 ) , a child with chronic illness in the home ( OR 3.4 , 95 % CI 1.5–7.9 ) , increased crowding in the home ( OR 2.7 , 95 % CI 1.3–5.6 ) , unemployment ( OR 3.1 , 95 % CI 1.2–7.9 ) , and poor coping skills ( OR 3.8 , 95 % CI 1.7–8.7 ) , were significantly associated with low birth weight delivery ( P < .01 for all comparisons ) . These significant associations persisted after adjusting for maternal age in multivariable analysis . CONCLUSION : This study provides evidence that chronic psychosocial stress may be associated with low birth weight neonates in a low-income population of women . LEVEL OF EVIDENCE : 
    Output:
    
Food insecurity was associated with increased sexual risk through transactional sex and inability to negotiate safer sex .
Hunger and food insecurity were barriers to ART initiation/adherence .