{ "abstract": "Although recent literature increasingly recognizes HIV, food insecurity, water insecurity, and depression as interconnected syndemics, research simultaneously evaluating the role of all these factors is limited among people living with HIV. We assessed the associations between water insecurity and food insecurity and how they relate to depression among people living with HIV in Ghana. This was a cross-sectional analysis of the baseline data of an ongoing cohort in three regions of Ghana. PHQ-9 depression scale was used, summed up to generate a depression score, which was then recoded into 4 categories of ‘none-minimal’,’mild’,’moderate’, and ‘severe’. Multivariable ordered logistic regression analysis (controlling for a priori identified confounders) was used to quantify the association between water insecurity and depression. Overall average depression score was 5.88 (SD = 4.82), with 47.1% of the participants having ‘none-minimal’ depression, 32.2% having mild, 19.9% having moderate, and only 0.8% having severe depression. In the multivariate model, depression was more prevalent among participants experiencing low (aOR = 1.96; 95% CI: 1.30–2.95) or moderate water insecurity (aOR = 2.64; 95% CI: 1.45–4.82), and moderate (aOR = 2.22; 95% CI: 1.27–3.87) or high food insecurity (aOR = 3.32; 95% CI: 2.22–4.95). Higher odds of depression were also observed among females (aOR = 1.73; 95% CI: 1.23–2.44), and those reporting moderate (aOR = 6.22; 95% CI: 1.85–20.86) or high perceived stress (aOR = 21.07; 95% CI: 6.75–65.80). Lower odds of depression was observed among widowed women (aOR = 0.61; 95% CI: 0.41–0.86). The study demonstrates that both water insecurity and food insecurity are strongly associated with depression among people living with HIV. The substantially higher odds of depression among women and those experiencing moderate to high perceived stress highlight the importance of incorporating gender-responsive and stress-focused mental health interventions into HIV care.", "abstract_shown": true, "affiliations": [ "Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, United States of America", "Africa Interdisciplinary Research Institute, Accra, Ghana", "School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana", "Infectious Diseases Research Collaboration, Kampala, Uganda", "Department of Anthropology, Institute for Policy Research, and Center for Water Research, Northwestern University, Evanston, Illinois, United States of America", "Language Center, College of Humanities, University of Ghana, Accra, Ghana", "Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America", "Division of Prevention Science, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America", "Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, United States of America", "Institute of Work Employment and Society, University of Professional Studies, Accra, Ghana", "Navrongo Health Research Centre, Navrongo, Ghana" ], "article_type": "Research Article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0 ], "name": "Jerry John Ouner" }, { "affs": [ 1 ], "name": "Agani Afaya" }, { "affs": [ 2 ], "name": "Jaffer Okiring" }, { "affs": [ 3 ], "name": "Sera Young" }, { "affs": [ 4 ], "name": "Rachel G. A. Thompson" }, { "affs": [ 5 ], "name": "Torsten B. Neilands" }, { "affs": [ 6 ], "name": "Tarik Benmarhnia" }, { "affs": [ 7 ], "name": "Isaac Yeboah" }, { "affs": [ 8 ], "name": "Raymond Aborigo" }, { "affs": [ 9 ], "name": "Monica Getahun" }, { "affs": [ 10 ], "name": "Sheri Weiser" } ], "bibtex": "https://research.draconitic.com/paper/15paef8h6nywp.bib", "cited_by": 0, "doi": "10.1371/journal.pwat.0000546", "fulltext_url": "https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000546", "id": "15paef8h6nywp", "issns": [ "2767-3219" ], "landing_url": "https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000546", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/RNA viruses/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Psychology/Psychological stress" ], [ "plos", "/Earth sciences/Seasons" ], [ "plos", "/Ecology and environmental sciences/Natural resources/Water resources" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry/Mood disorders/Depression" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry/Psychological stress" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Hygiene" ], [ "plos", "/People and places/Geographical locations/Africa/Ghana" ], [ "plos", "/Social sciences/Psychology/Psychological stress" ] ], "openalex": null, "pdf_url": "https://journals.plos.org/water/article/file?id=10.1371/journal.pwat.0000546&type=printable", "pmcid": null, "pmid": null, "published": "2026-11-04", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/15paef8h6nywp.ris", "sources": [ { "first_seen": "2026-11-05T12:20:11Z", "native_id": "10.1371/journal.pwat.0000546", "source": "plos", "url": "https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000546" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:mental health and psychiatry", "subfield": "psychiatry" } ], "title": "Examining the association between household water insecurity, food insecurity and depression among people living with HIV in Ghana", "title_text": "Examining the association between household water insecurity, food insecurity and depression among people living with HIV in Ghana", "type": "peer-reviewed", "updated_at": "2026-11-06T12:20:42Z", "url": "https://research.draconitic.com/paper/15paef8h6nywp", "venue": "PLOS Water", "versions": [] }