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. 2012 Jan 2;26(1):67-75.
doi: 10.1097/QAD.0b013e32834cad37.

Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting

Sheri D Weiser  1 , Alexander C Tsai, Reshma Gupta, Edward A Frongillo, Annet Kawuma, Jude Senkungu, Peter W Hunt, Nneka I Emenyonu, Jennifer E Mattson, Jeffrey N Martin, David R Bangsberg
Affiliations

Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting

Sheri D Weiser et al. AIDS. .

Abstract

Objective: We undertook a longitudinal study in rural Uganda to understand the association of food insecurity with morbidity and patterns of healthcare utilization among HIV-infected individuals enrolled in an antiretroviral therapy program.

Design: Longitudinal cohort study.

Methods: Participants were enrolled from the Uganda AIDS Rural Treatment Outcomes cohort, and underwent quarterly structured interviews and blood draws. The primary predictor was food insecurity measured by the validated Household Food Insecurity Access Scale. Primary outcomes included health-related quality of life measured by the validated Medical Outcomes Study-HIV Physical Health Summary (PHS), incident self-reported opportunistic infections, number of hospitalizations, and missed clinic visits. To estimate model parameters, we used the method of generalized estimating equations, adjusting for sociodemographic and clinical variables. Explanatory variables were lagged by 3 months to strengthen causal interpretations.

Results: Beginning in May 2007, 458 persons were followed for a median of 2.07 years, and 40% were severely food insecure at baseline. Severe food insecurity was associated with worse PHS, opportunistic infections, and increased hospitalizations (results were similar in concurrent and lagged models). Mild/moderate food insecurity was associated with missed clinic visits in concurrent models, whereas in lagged models, severe food insecurity was associated with reduced odds of missed clinic visits.

Conclusion: Based on the negative impact of food insecurity on morbidity and patterns of healthcare utilization among HIV-infected individuals, policies and programs that address food insecurity should be a critical component of HIV treatment programs worldwide.

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Conflict of interest statement

Conflicts of interest

There are no conflicts of interest.

Comment in

References

    1. The National Agricultural Advisory Services. The impact of HIV/AIDS on the agricultural sector and rural livelihoods in Uganda. Uganda: The National Agricultural Advisory Services; 2003.
    1. ORC/Macro, editor. Uganda HIV/AIDS Sero-Behavioral Survey, 2004–2005. UMoHa; Kampala, Uganda: 2006.
    1. Normen L, Chan K, Braitstein P, Anema A, Bondy G, Montaner JS, et al. Food insecurity and hunger are prevalent among HIV-positive individuals in British Columbia, Canada. J Nutr. 2005;135:820–825. - PubMed
    1. Bukusuba J, Kikafunda JK, Whitehead RG. Food security status in households of people living with HIV/AIDS (PLWHA) in a Ugandan urban setting. Br J Nutr. 2007;98:211–217. - PubMed
    1. Mbugua S, Andersen N, Tuitoek P, Yeudall F, Sellen D, Karanja N, et al. Assessment of food security and nutrition status among households affected by HIV/AIDS in Nakuru Municipality, Kenya. XVII International AIDS Conference; Mexico City. 2008.

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