243909 Applying New Theoretical Models to Address Structural Drivers of Food Security and HIV/AIDS - Moving Policy From Short-term Solutions to a Sustainable Response

Monday, October 31, 2011

Robert H. Salerno, BA , Global Health Science | School of Medicine, University of California, San Francisco, San Francisco, CA
Sheri Weiser, MD, MPH , Center for AIDS Prevention Studies, University of California- San Francisco, San Francisco, CA
Colleen Green, MALD , Global Health, DAI, Bethesda, MD
Benjamin Hickler, PhD , Cummings School of Veterinary Medicine, Tufts Unviersity, Westboro, MA
Jessica deJarnette, BS , Medicine, Georgia Health Sciences Unviersity, Augusta, GA
Charles Vaughan, BS , Global Health Sciences, University of California, San Francisco, San Francisco, CA
Craig Cohen, MD, MPH , OB/GYN and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
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.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1) Define food security and discuss the structural drivers of food security and HIV/AIDS; 2) Discuss the pathways to food insecurity based on various evidence-based theoretical models; 3) Describe the evidence-base that informs these models; 4) Compare the challenges and successes to implementing a cross-disciplinary food security intervention for PLWHAS; 5) Demonstrate the need for further analysis and policy changes

Keywords: Food Security, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As an international development practitioner, I am qualified to present on this topic from years of experience in program design and implementation focusing on areas such as food security, urban agriculture, HIV/AIDS prevention and "One Health" zoonotic disease capacity building programs. A former Peace Corps volunteer and development practitioner on various USAID-funded programs, I am completing my masters degree and will begin doctoral studies in the fall of 2012.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.