Background: Food and water insecurity are associated with poor health outcomes that may be exacerbated by social marginalization and barriers to healthcare experienced by sexual- and gender-minorities (SGM) in resource-limited settings. We explored factors associated with food and water insecurity in SGM with HIV. Setting: A longitudinal study of 357 men who have sex with men (MSM), transgender women (TGW), and other gender-identifying people in Lagos, Nigeria. Methods: Laboratory testing, interviews, food and water assessments, and anthropometry were performed quarterly. Robust Poisson regression with generalized estimating equations was used to evaluate factors potentially associated with food and water insecurity. Results: From 2014–2018, 357 SGM with HIV completed either the food or water assessments. At baseline, participants identified as cisgender MSM 265(74.2%), TGW 63(17.7%), or as non-binary/other gender 29(8.1%). Food insecurity and water insecurity were reported by 63/344(18.3%) and 113/357(31.7%), respectively at any visit. Food and water insecurity each decreased with ongoing study participation. Food insecurity was associated with non-partnered relationship status, CD4 count <500 cells/mm^{3}, and lack of access to piped water. Water insecurity was associated with age ≥25 years, living with a man, transactional sex, and food insecurity. Conclusion: Food and water insecurity were common among SGM in Nigeria and decreased with continued study participation, suggesting amenability to intervention when SGM are successfully engaged in care. Targeted interventions to support food and water security may improve HIV-related outcomes, such as CD4 count.
【저자키워드】 HIV, food insecurity, Nigeria, men who have sex with men, Transgender women, other gender identity, water insecurity,