. 2019 Feb 1;149(2):240-248.

doi: 10.1093/jn/nxy203.

Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States

Emily L Tuthill¹, Lila A Sheira², Kartika Palar², Edward A Frongillo³, Tracey E Wilson⁴, Adebola Adedimeji⁵, Daniel Merenstein⁶, Mardge H Cohen⁷, Eryka L Wentz⁸, Adaora A Adimora⁹, Ighovwerha Ofotokun^{10

11}, Lisa Metsch¹², Margot Kushel¹³, Janet M Turan¹⁴, Deborah Konkle-Parker¹⁵, Phyllis C Tien^{16

17}, Sheri D Weiser^{2

18}

Affiliations

¹ Department of Community Health Systems, School of Nursing, San Francisco, San Francisco, CA.
² Division of HIV, Infectious Disease, and Global Medicine, San Francisco, San Francisco, CA.
³ Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC.
⁴ Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, NY.
⁵ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
⁶ Department of Family Medicine, Georgetown University Medical Center, Washington, DC.
⁷ Department of Medicine, Stroger Hospital, Chicago, IL.
⁸ Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
⁹ School of Medicine and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
¹⁰ School of Medicine, Emory University, Atlanta, GA.
¹¹ Grady Healthcare System, Atlanta, GA.
¹² Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY.
¹³ Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, San Francisco, CA.
¹⁴ Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
¹⁵ Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS.
¹⁶ Department of Medicine, San Francisco, San Francisco, CA.
¹⁷ Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA.
¹⁸ Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA.

PMID: 30753638
PMCID: PMC6698636
DOI: 10.1093/jn/nxy203

Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States

Emily L Tuthill et al. J Nutr. 2019.

. 2019 Feb 1;149(2):240-248.

doi: 10.1093/jn/nxy203.

Authors

Affiliations

¹ Department of Community Health Systems, School of Nursing, San Francisco, San Francisco, CA.
² Division of HIV, Infectious Disease, and Global Medicine, San Francisco, San Francisco, CA.
³ Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC.
⁴ Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, NY.
⁵ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
⁶ Department of Family Medicine, Georgetown University Medical Center, Washington, DC.
⁷ Department of Medicine, Stroger Hospital, Chicago, IL.
⁸ Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
⁹ School of Medicine and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
¹⁰ School of Medicine, Emory University, Atlanta, GA.
¹¹ Grady Healthcare System, Atlanta, GA.
¹² Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY.
¹³ Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, San Francisco, CA.
¹⁴ Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
¹⁵ Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS.
¹⁶ Department of Medicine, San Francisco, San Francisco, CA.
¹⁷ Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA.
¹⁸ Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA.

PMID: 30753638
PMCID: PMC6698636
DOI: 10.1093/jn/nxy203

Abstract

Background: Food insecurity and mental health negatively affect the lives of women in the United States. Participants in the Women's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time.

Objective: We investigated the association between current and persistent food insecurity and depression among women at risk of or living with HIV in the United States.

Methods: We used longitudinal data from the WIHS, a prospective cohort study in women at risk of or living with HIV from multiple sites in the United States. Participants completed 6 semiannual assessments from 2013 to 2016 on food security (FS; high, marginal, low, and very low) and mental health (i.e., depressive symptoms and mental well-being). We used multiple regression analysis to estimate the association between these variables.

Results: Among 2551 participants, 44% were food insecure and 35% reported depressive symptoms indicative of probable depression. Current marginal, low, and very low FS were associated with 2.1-, 3.5-, and 5.5-point (all P < 0.001) higher depression scores, respectively. In models adjusting for both current and previous FS, previous marginal, low, and very low FS were associated with 0.2-, 0.93-, and 1.52-point higher scores, respectively (all P < 0.001). Women with very low FS at both time points (persistent food insecurity) had a 6.86-point higher depression score (P < 0.001). In the mental health models, there was a dose-response relation between current FS and worse mental health even when controlling for previous FS (all P < 0.001). Previous low FS was associated with worse mental health. These associations did not differ by HIV status.

Conclusions: Food insecurity placed women at risk of depression and poor mental well-being, but the risk was substantially higher for women experiencing persistent food insecurity. Future interventions to improve women's mental health call for multilevel components that include addressing food insecurity.

Keywords: HIV; United States; food insecurity; mental health; women.

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Comment in

Persistent Food Insecurity's Association with Mental Health of Women Living With or at Risk of HIV: A Call to Action.
Metallinos-Katsaras E. Metallinos-Katsaras E. J Nutr. 2019 Feb 1;149(2):179-180. doi: 10.1093/jn/nxy294. J Nutr. 2019. PMID: 30753535 No abstract available.

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Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States

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Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States

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