Food Insecurity is Associated with Poor HIV Outcomes Among Women in the United States

Matthew A Spinelli; Edward A Frongillo; Lila A Sheira; Kartika Palar; Phyllis C Tien; Tracey Wilson; Daniel Merenstein; Mardge Cohen; Adebola Adedimeji; Eryka Wentz; Adaora A Adimora; Lisa R Metsch; Janet M Turan; Margot B Kushel; Sheri D Weiser

doi:10.1007/s10461-017-1968-2

Food Insecurity is Associated with Poor HIV Outcomes Among Women in the United States

AIDS Behav. 2017 Dec;21(12):3473-3477. doi: 10.1007/s10461-017-1968-2.

Authors

Affiliations

¹ Division of Infectious Disease, University of California, San Francisco, USA. Matthew.Spinelli@UCSF.edu.
² Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
³ Division of HIV, ID and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
⁴ Department of Medicine, University of California, San Francisco and Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA, USA.
⁵ Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, NY, USA.
⁶ Department of Family Medicine, Georgetown University Medical Center, Washington, DC, USA.
⁷ Department of Medicine, Stroger Hospital, Chicago, IL, USA.
⁸ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
⁹ Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
¹⁰ School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹¹ Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
¹² Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
¹³ Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco (UCSF), San Francisco, CA, USA.

Abstract

Women in the general population experience more food insecurity than men. Few studies have examined food insecurity's impact on HIV treatment outcomes among women. We examined the association between food insecurity and HIV outcomes in a multi-site sample of HIV-infected women in the United States (n = 1154). Two-fifths (40%) of participants reported food insecurity. In an adjusted multivariable Tobit regression model, food insecurity was associated with 2.08 times higher viral load (95% confidence interval (CI): 1.04, 4.15) and lower CD4+ counts (- 42.10, CI: - 81.16, - 3.03). Integration of food insecurity alleviation into HIV programs may improve HIV outcomes in women.

Keywords: Food insecurity; HIV; Viral load; Women.

MeSH terms

Adult
Anti-HIV Agents / therapeutic use*
CD4 Lymphocyte Count
Female
Food Supply*
HIV Infections / drug therapy*
HIV Infections / epidemiology
HIV Infections / virology
Humans
Longitudinal Studies
Male
Medication Adherence*
Prospective Studies
Treatment Outcome
United States / epidemiology
Viral Load*

Substances

Anti-HIV Agents

Abstract

MeSH terms

Substances

Grants and funding