In the Journals Plus

Patients with HIV in British Columbia frequently report food insecurity

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August 16, 2016

Recently published data suggest nearly three-quarters of people with HIV living in British Columbia could be experiencing poor dietary quality or insufficient food procurement.

These needs appear to be associated with a number of factors, including unstable housing, age and low annual household income, according to the analysis, and indicate a need for social support and food security interventions for this affected population.

“Food insecurity is prevalent among people living with HIV in North America, and associated with numerous socio-demographic and behavioral factors including low-income status, unstable housing and a history of tobacco and illicit drug use,” Aranka Anema, PhD, research fellow in pediatrics at Harvard Medical School and vice president of Epidemico Inc., and colleagues wrote. “Additionally, evidence supports an association between food insecurity and symptoms of depression, greater acute care utilization and adverse ART outcomes, including suboptimal adherence, immunological and virological response and survival.”

Anema and colleagues analyzed data from a Canadian national study of HIV patients’ dietary habits administered between March 2011 and August 2012. They examined the food security of participants who reported residence in British Columbia, were not recently pregnant and could provide adequate dietary information. The researchers determined the proportion of participants whose responses demonstrated food insecurity, and conducted additional analysis to identify contributing factors.

A total of 262 participants were included in the final analysis. Of these, 73% were male, 35% reported indigenous ancestry. The median age of the participants was 47 years.

The researchers identified 73% of respondents as being food insecure. Question topics eliciting the greatest responses included those describing food sufficiency anxiety (70%), food running out (72%) and an inability to afford balanced meals (72%). After controlling for potential confounders, multivariate analyses identified a number of factors associated with food insecurity, including: non-traditional methods of food procurement (adjusted OR = 11.11; 95% CI, 4.79-25.68); younger age (aOR = 0.92; 95% CI, 0.86-0.96); unstable housing (AOR = 4.46; 95% CI, 1.15-17.36); household gross annual income (aOR = 4.49; 95% CI, 1.74-11.6); and depression symptoms (aOR = 2.73; 95% CI, 1.25-5.96).

These findings corroborate those reported in a prior HIV cohort using a different gauge of food security, the researchers wrote. The results also suggest that the proportion of individuals with HIV experiencing food insecurity is nine times greater than that of the general population of British Columbia and suggest a benefit to aligning food supplementation programs with other HIV, sexual health or harm reduction programs.

“Our study provides essential data to guide evidence-based local programs and policies aimed at preventing and mitigating food insecurity among people living with HIV,” the researchers wrote. “Future operational research is needed to assess the effectiveness of structural interventions aimed at strengthening dietary quality and social access to food in this setting.” – by Dave Muoio

Disclosure: The researchers report no relevant financial disclosures.

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