HIV affected households in Western Kenya experience greater food insecurity

•Households that have an adult who is HIV positive, are likely to be food insecure in a low income country like Kenya.•In addition, hosting orphans in HIV affected households makes the food insecurity situation worse.•Women headed households are even more food insecure. This was a cross-sectional study conducted in the first Millennium Village in Western Kenya. We compared the food security status of households affected by HIV/AIDS to households not affected by HIV/AIDS. We also identified coping strategies adopted by members of food insecure households. 315 Households were included in the study, consisting of 169 HIV affected households, (44 households with self-identified HIV positive adults, 80 households with orphans, and 45 households with both orphans and self-identified HIV positive adults). These households were compared to 146 HIV unaffected households. Food security status was measured using the Household Food Insecurity Access Scale Indicator (HFIAS) guide. Coping strategies were measured using the Coping Strategies Index (CSI). HIV affected households had a significantly higher food insecurity score 11.11, compared to 9.53 in HIV unaffected households (p=0.037). Female headed households had the worst food security, regardless of household type. There were also significant difference in the coping strategies scores between HIV affected (64.48) and unaffected households (50.31) (p=0.004). HIV affected households were associated with more severe coping strategies. The food security of HIV affected households is compromised by a variety of factors including the synergy generated by hosting a HIV positive family member and orphans. The gender of the household head is also an important consideration. Households headed by women tend to be more vulnerable, predisposing households to greater food insecurity.