Water and food insecurity and linkages with physical and sexual intimate partner violence among urban refugee youth in Kampala, Uganda: cross-sectional survey findings

Abstract Water insecurity (WI) and food insecurity (FI), each associated with violence exposure, are understudied in urban humanitarian settings. We conducted a cross-sectional survey with urban refugee youth in Kampala, Uganda to examine: (a) social-ecological correlates of WI, FI, and concurrent FI and WI; (b) associations between WI and FI with recent sexual and physical intimate partner violence (IPV); and (c) associations between an Index of Vulnerability (IoV) comprised of social-ecological stressors (e.g., FI, WI) and recent physical/sexual IPV. Among participants (n = 340; mean age: 21.1 years, standard deviation: 2.6) almost half (47.8%) reported WI and two-thirds (65.0%) FI. In adjusted analyses, time in Uganda, age, and insecure housing were associated with increased odds of WI and concurrent FI and WI; household toilet sharing and insecure housing were associated with increased odds of FI. In adjusted analyses, WI, concurrent FI and WI, housing insecurity, and parenthood were associated with higher sexual IPV odds. FI and parenthood were associated with increased odds of physical IPV. IoV scores were associated with physical/sexual IPV, and IoV scores accounted for more variance in physical/sexual IPV than any individual indicator. Future research can address WI and co-occurring resource insecurities to reduce gender-based water-related violence risks.