Applying New Theoretical Models to Address Structural Drivers of Food Security and HIV/AIDS - Moving Policy From Short-term Solutions to a Sustainable Response

Issue: Despite the proliferation of food security interventions targeting PLWHAs, few programs exist that integrate small-scale agriculture, access to credit, ecosystem health, and soil and water conservation. Through the use of collaborative, multi-sectoral approaches to food security and HIV/AIDS, interventions can leverage diverse expertise to better impact agricultural, economic and health outcomes.

Description: Food insecurity and HIV/AIDS function in a complicated cycle with each condition increasing the vulnerability to and exacerbating severity of the other. Although food insecurity is most often approached at the household level, structural drivers including changing environmental conditions, household economic status and social factors (e.g, HIV-related stigma, gender inequality) negatively impact communities and in turn, increase food insecurity. Several evidence-based theoretical models demonstrate the consequences of structural drivers that shape individual behaviors and health outcomes through nutritional, mental-health, and behavioral pathways. By implementing a household-focused agricultural livelihoods approach, households will improve nutritional and economic status, reduce food seeking anxiety, and individuals may engage in less risky behaviors that can lead to HIV transmission and acquisition. Collaborations between Ministries of Health and Agriculture coupled with improving individuals access to microfinance (savings and credit) increase programmatic sustainability while simultaneously addressing structural drivers that lead to food insecurity.

Lessons Learned: Livelihood interventions that confront the root causes of food insecurity may improve health outcomes and decrease HIV transmission by addressing numerous pathways.

Recommendations: Further analysis must address other structural drivers incorporating property rights and market access to improve livelihood and health outcomes.