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NAIROBI, (PlusNews) - Women in food insecure southern Africa are putting themselves in danger of contracting HIV in their desperation to feed themselves and their families, a new study has found.

"For people in sub-Saharan Africa, insufficient food for their daily needs and infection with the human immunodeficiency virus [HIV] are inextricably linked and major causes of illness and death," it said. "Women in both countries who reported food insufficiency were nearly twice as likely to have used condoms inconsistently with a non-regular partner or to have sold sex."

The study - published in the October edition of the Public Library of Science Medicine journal and led by Dr Sheri Weiser of the University of California, San Francisco - investigated the association between food insufficiency and inconsistent condom use, sex exchange, and other measures of risky sex among 1,255 adults in Botswana and 796 adults in Swaziland.

Over the past few years, many southern African countries have suffered severe food shortages, and according to the UN World Food Programme (WFP), Swaziland has just had its worst harvest in living memory, with only 26,000 tonnes of maize reaped during the 2007 harvest. An estimated 400,000 people are thought to need food aid, which is more than one-third of the country's population.

"As a result of severe food insecurity, people develop negative coping mechanisms, or ways of survival that have harmful effects on their lives," Richard Lee, WFP's media officer in Johannesburg, South Africa, told IRIN/PlusNews. "These include eating fewer meals, migration, pulling kids out of school and often, girls and women exchanging sex for food."

Lee said the burden was particularly heavy on women because they were not only expected to feed their immediate families, but also relatives such as grandparents and orphans.

"Clearly the situation is more worrying in southern Africa, where food insecurity is so serious and the HIV prevalence is so high," he added. "Swaziland and Botswana, for instance, have some of the highest HIV rates in the world, so the chances of contracting the virus from transactional sex for food - particularly given how little control they have over using protection - are high."

Nearly one in three women and one in three men in the study reported food insecurity. It found that in addition to unprotected sex, these women were also more likely to have had cross-generational sexual relationships and to report a lack of control in sexual relationships.

In western Zambia, which suffers from pockets of food insecurity, coping strategies have been tested, largely because the AIDS pandemic has left families caring for large numbers of orphans, while AIDS-related deaths have reduced the productivity of families, further affecting the amount of food farmed.

"You find women in many of the border towns and major trading routes exchanging sex for food. They'll say: 'I know HIV is going to kill me but I still have to feed my kids; hunger will kill me tomorrow but AIDS will kill me in a few years'," said Paul Macek, country representative in Zambia for the NGO, Catholic Relief Services (CRS). "The knowledge of HIV is good, but the need for food overrides it."

The study recommended improving food security through targeted food assistance and supporting women's subsistence farming as ways to break the cycle of sex for food.

"Such programmes would also need to enhance women's legal and social rights so that they have more control over food supplies as well as their sexual lives," it said.

CRS has a 'social safety-net' programme designed to provide food to families identified by their communities as being in special need. The organisation also gives food to HIV patients on life-prolonging antiretroviral medication.

"It's important to ensure that we provide food so that people won't have to resort to these measures," Lee said. "WFP is mainstreaming HIV into our programming, meaning we consider HIV in our programme design and implementation."

He said WFP was hoping to feed 365,000 of the 400,000 Swazis in need of food assistance until the next harvest in April 2008.

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