High prevalence of food insecurity among HIV-infected individuals receiving HAART in a resource-rich setting

Abstract

This study aimed to assess the prevalence and correlates of food insecurity in a cohort of HIV-infected individuals on highly active antiretroviral therapy (HAART) in British Columbia (BC), Canada. Adults receiving HAART voluntarily enrolled into the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) cohort. Individual food insecurity was measured using a modified version of the Radimer/Cornell Questionnaire. We performed bivariate analyses to determine differences between explanatory variables for individuals who were food secure and food insecure. We performed logistic regression to determine independent predictors of food insecurity. Of the 457 individuals enrolled in the LISA cohort, 324 (71.0%) were found to be food insecure. Multivariate analysis indicated that individuals who had an annual incomes less than $15,000 (odds ratio [OR] 3.15, 95% confidence interval [CI] 1.83, 5.44), used illicit drugs (OR 1.85, 95% CI 1.03, 3.33), smoked tobacco (OR 2.30, 95% CI 1.30, 4.07), had depressive symptoms (OR 2.34, 95% CI 1.38, 3.96), and were younger (OR 0.95, 95% CI, 0.92, 0.98) were more likely to be food insecure. Our results demonstrated a high (71%) prevalence of food insecurity among HIV-infected individuals receiving HAART in this resource-rich setting, and that food insecurity is associated with a compendium of environmental and behavioral factors. More research is needed to understand the biological and social pathways linking food insecurity to these variables in order to identify program strategies that can effectively improve food security among HIV-infected populations.

Keywords:

• food security
• HIV
• antiretroviral therapy
• HAART

Acknowledgements

We would like to thank participants in LISA cohort for their willingness to participate in the study. We would also like to thank additional members of LISA study team at the British Columbia Centre for Excellence in HIV/AIDS whom helped contribute to this project.

This study was supported through funding from the Canadian Institute of Health Research (CIHR). A. Anema received grant support from CIHR and the Ontario HIV Treatment Network (OHTN). S.D. Weiser received support from the National Institute of Mental Health (NIMH) K23 MH079713-01 and the California HIV/AIDS Research Program ID08-SF-054. R.S. Hogg has held grant funding from the National Institutes of Health (NIH), CIHR, National Health Research Development Program, and Health Canada. R.S. Hogg has also received funding from Agouron Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals Inc., Bristol-Myers Squibb, GlaxoSmithKline, and Merck Frosst Laboratories for participating in continued medical education programes. J.S.G. Montaner has received grants from, served as an ad hoc advisor to, or spoken at various events sponsored by Abbott, Argos Therapeutics, Bioject Inc., Boehringer Ingelheim, BMS, Gilead Sciences, GlaxoSmithKline, Hoffmann-La Roche, Janssen-Ortho, Merck Frosst, Pfizer, Schering, Serono Inc., TheraTechnologies, Tibotec, and Trimeris. J.S.G. Montaner has held grant funding from CIHR and NIH. He has also received funding for research and continuing medical education programs from a number of pharmaceutical companies including Abbott, Boehringer Ingelheim, and GlaxoSmithKline.

Funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.