Food Insecurity and Sexually Transmitted Infections in the United States.

BACKGROUND: Individual food insecurity, defined as having limited or uncertain access to food of sufficient quality and quantity, is associated with increased sexual risk behavior and diagnosis of a sexually transmitted infection (STI), even after accounting for measures of socioeconomic status. Little is known about how food stress at the community level may exacerbate sexual and social vulnerabilities, or its potential association to a higher rate of STIs at the county level.

METHODS: We conducted an ecological analysis of the association between county-level reported rates of chlamydia, gonorrhea, and primary and secondary syphilis, with rates of food insecurity net of socioeconomic controls in the United States. The moderating effect of county-level estimates of the Supplemental Nutrition Assistance Program (SNAP) adequacy-the SNAP meal gap-was assessed.

RESULTS: The results show that food insecurity and the SNAP meal gap were both positively associated with bacterial STI burden at the county level, even after controlling for poverty and other sociodemographic characteristics. The association between food insecurity and STI rates is more pronounced in counties where the average SNAP allocation is inadequate to cover the cost of meals.

CONCLUSIONS: This study serves as a first step toward understanding how food insecurity may function as an additional stressor on communities struggling with high rates of STIs. These findings underscore the importance of considering food insecurity not only as an economic hardship but also as a potential contributor to community-level sexual health disparities. This study provides more evidence that food assistance programs may play a critical role in shaping population health outcomes.