Intersecting Syndemics of Household Water Insecurity and HIV/AIDS: Implications for Dermatological Health among People Living with HIV in Kenya

Objectives: In tropical and resource-poor settings where household water insecurity is prevalent, the risk of dermatological conditions is significantly high among People living with HIV (PLHIV). However, no study has examined the nature of this relationship in Kenya. Thus, this study assessed the effect of water insecurity on dermatological conditions among PLHIV in Kenya. Methods: Data for this study were drawn from the Resource Insecurity and Well-being Study with a focus on PLHIV in Kenya (N = 1,132). Data collected included measures of household water insecurity experiences, dermatological conditions, use of improved/unimproved water sources, environmental risk factors, and sociodemographic factors. Following descriptive and bivariate analysis, complementary log-log regression models assessed the effect of water insecurity on each skin condition in three multivariate models. This was followed by predicted probabilities that examined the intersecting syndemics of water insecurity over water source and gender. Results: Of the 1,132 PLHIV, 16.2% reported having skin infections, 16.3% experienced skin itching, and 9.4% experienced skin sores in the last month. In the multivariate models, water insecurity was a significant predictor of skin infections (OR: 1.03; 95% CI: 1.01, 1.04), skin itching (OR: 1.02, 95% CI: 1.01, 1.03) and skin sores (OR: 1.04, 95% CI: 1.02, 1.06). The interaction between water insecurity and improved water sources showed a decrease in skin sores and itching odds. Conclusions: Household water insecurity is a significant predictor of dermatological conditions among PLHIV. Policies aimed at improving access to clean water and sanitation are essential in promoting their well-being.