Examining the association between household water insecurity, food insecurity and depression among people living with HIV in Ghana
11 affiliations
- 1Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, United States of America
- 2Africa Interdisciplinary Research Institute, Accra, Ghana
- 3School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- 4Infectious Diseases Research Collaboration, Kampala, Uganda
- 5Department of Anthropology, Institute for Policy Research, and Center for Water Research, Northwestern University, Evanston, Illinois, United States of America
- 6Language Center, College of Humanities, University of Ghana, Accra, Ghana
- 7Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
- 8Division of Prevention Science, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
- 9Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, United States of America
- 10Institute of Work Employment and Society, University of Professional Studies, Accra, Ghana
- 11Navrongo Health Research Centre, Navrongo, Ghana
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.
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BibTeX
@article{ouner2026examining,
title = {{Examining the association between household water insecurity, food insecurity and depression among people living with HIV in Ghana}},
author = {Jerry John Ouner and Agani Afaya and Jaffer Okiring and Sera Young and Rachel G. A. Thompson and Torsten B. Neilands and Tarik Benmarhnia and Isaac Yeboah and Raymond Aborigo and Monica Getahun and Sheri Weiser},
journal = {PLOS Water},
year = {2026},
month = nov,
doi = {10.1371/journal.pwat.0000546},
url = {https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000546},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Examining the association between household water insecurity, food insecurity and depression among people living with HIV in Ghana
AU - Jerry John Ouner
AU - Agani Afaya
AU - Jaffer Okiring
AU - Sera Young
AU - Rachel G. A. Thompson
AU - Torsten B. Neilands
AU - Tarik Benmarhnia
AU - Isaac Yeboah
AU - Raymond Aborigo
AU - Monica Getahun
AU - Sheri Weiser
PY - 2026
DA - 2026/11/04
JO - PLOS Water
DO - 10.1371/journal.pwat.0000546
UR - https://journals.plos.org/water/article?id=10.1371/journal.pwat.0000546
AB - 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.
SN - 2767-3219
ER -