Prevalence and predictors of food insecurity among people living with HIV affiliated with AIDS service organizations in Ontario, Canada

ABSTRACT

Up to half of people living with HIV in resource-rich settings experience moderate to severe food insecurity. Food insecurity, in turn, has been linked to adverse health outcomes including poor antiretroviral adherence, poor HIV viral suppression, frailty, and mortality. We estimated the prevalence of food insecurity among 649 adults living with HIV and recruited from community-based AIDS service organizations in Ontario, Canada. Food security was assessed using the Canadian Household Food Security module. We used logistic regression modeling to identify demographic, socioeconomic, and psychosocial factors independently associated with food insecurity. Almost three-fourths of participants (70.3%) were food insecure and a third (31%) reported experiencing hunger. The prevalence of food insecurity in this sample is approximately six times higher than that of the general population. Factors independently associated with food insecurity were: having dependent children at home, residing in large urban areas, low annual household income (<$40,000), difficulty meeting housing-related expenses, cigarette smoking, harmful drug use, and depression. Broad, multisector interventions that address income, housing affordability, substance use and mental health issues are needed and could offset future public health expenditures.

KEYWORDS:

• Food insecurity
• hunger
• people living with HIV

Acknowledgments

The authors wish to thank peer research associates Scott de Blois, Brenda Gagnier, Gary Logie, Paul F. Kogan, Mary Mwalwanda, Lynne Cioppa, J. Lauzon, James Gough, R.K, C.J.R, and T. Walker who helped with recruitment and conducted face-to-face interviews with participants in Ontario. We thank all study participants and the community-based AIDS service organizations for their support to this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The “Impact of Food Security on Health Outcomes in People Living with HIV Across Canada” was funded by a grant from the Canadian Institutes of Health Research (grant number CBR-99148).