Assessing the Health Outcomes of the Food Access Pilot Project: An Evaluation of a Medically Supportive Food Support Program for People Living with HIV in Rural California Counties

Abstract

Food insecurity disproportionately affects rural communities and people living with HIV (PLHIV). The Food Access Pilot Project (FAPP) was a California state-funded program that provided home-delivered, medically supportive meals via online meal vendors to food-insecure PLHIV in three rural counties. We performed longitudinal, retrospective analyses of FAPP participant data (n = 158; 504 and 460 person-time observations for viral load and CD4 count, respectively) over 36 months from a Ryan White client management database. Pre-post analyses demonstrated increased prevalence of food security and CD4 ≥ 500 between baseline and 12 months. Population-averaged trends using generalized estimating equations adjusted for participant demographics demonstrated increased odds of viral suppression and CD4 ≥ 500, and increased CD4 count (cells/mm³) for every six months of program enrollment. Home-delivered, medically supportive meals may improve food security status, HIV viral suppression, and immune health for low-income PLHIV in rural settings.

Keywords: Food security; Food support; HIV; Medically supportive food; Rural.