Food insecurity and frailty among women with and without HIV in the United States: a cross-sectional analysis

Judy Y Tan; Lila A Sheira; Edward A Frongillo; Deborah Gustafson; Anjali Sharma; Daniel Merenstein; Mardge H Cohen; Elizabeth Golub; Andrew Edmonds; Igho Ofotokun; Margaret Fischl; Deborah Konkle-Parker; Torsten Neilands; Phyllis Tien; Sheri D Weiser

doi:10.1002/jia2.25751

Food insecurity and frailty among women with and without HIV in the United States: a cross-sectional analysis

J Int AIDS Soc. 2021 Jun;24(6):e25751. doi: 10.1002/jia2.25751.

Authors

Judy Y Tan¹, Lila A Sheira², Edward A Frongillo³, Deborah Gustafson⁴, Anjali Sharma⁵, Daniel Merenstein⁶, Mardge H Cohen⁷, Elizabeth Golub⁸, Andrew Edmonds⁹, Igho Ofotokun^{10

11}, Margaret Fischl¹², Deborah Konkle-Parker¹³, Torsten Neilands¹, Phyllis Tien¹⁴, Sheri D Weiser^{1

2}

Affiliations

¹ Center for AIDS Prevention Studies, University of California, San Francisco (UCSF), San Francisco, CA, USA.
² Division of HIV, ID and Global Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
³ Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
⁴ Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA.
⁵ Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
⁶ Department of Family Medicine, Georgetown University Medical Center, Washington, DC, USA.
⁷ Department of Medicine, Stroger Hospital of Cook County Health, Chicago, IL, USA.
⁸ WIHS Data Management Center, Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
⁹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁰ School of Medicine, Department of Medicine, Emory University, Atlanta, GA, USA.
¹¹ Grady Healthcare System, Atlanta, GA, USA.
¹² Miller School of Medicine, University of Miami, Coral Gables, FL, USA.
¹³ Department of Medicine/Division of Infectious Diseases, School of Nursing, School of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS, USA.
¹⁴ Department of Medicine, San Francisco and Medical Service, Department of Veteran Affairs Medical Center, University of California, San Francisco, CA, USA.

Abstract

Introduction: Frailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who may be particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV.

Methods: There were 1265 participants from the Women's Interagency HIV Study who participated in frailty assessments in 2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre-frail or frail. Food insecurity was assessed using the U.S. Household Food Security Survey Module, with women categorized as having high, marginal, low or very low food security. Multinomial logistic regression models were conducted to examine cross-sectional associations between food insecurity and frailty while adjusting for socio-demographic, behavioural and HIV status covariates.

Results and discussion: Approximately one-third (31.9%) of the women had marginal, low or very low food security, and the proportions of women who met the criteria for frailty or pre-frailty were 55.6% and 12.4% respectively. In the adjusted model, the relative risk ratio (RRR) of frailty for women with very low food security versus women with high food security was 3.37 (95% CI [1.38 to 8.24], p < 0.01); the corresponding RRR of pre-frailty was 3.63 (95% CI [1.76 to 7.51], p < 0.001). Higher annual household income was associated with lower RRRs of frailty or pre-frailty (p < 0.01). Similarly, older age was associated with more frequent frailty (RRR=1.06, 95% CI [1.03 to 1.09], p < 0.001). HIV serostatus was not significantly associated with either pre-frailty (RRR=0.97, 95% CI [0.71 to 1.31]) or frailty (RRR=0.75, 95% CI [0.48 to 1.16]).

Conclusions: Very low food security was associated with more frequent frailty and pre-frailty among women with and without for HIV. HIV serostatus was not associated with frailty.

Keywords: Food insecurity; HIV; frailty; women.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Cross-Sectional Studies
Female
Food Insecurity
Food Supply
Frailty* / epidemiology
HIV Infections* / epidemiology
Humans
United States / epidemiology

Abstract

Publication types

MeSH terms

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