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. 2022 Apr;25(4):930-943.
doi: 10.1017/S136898002100361X. Epub 2021 Aug 23.

Prevalence and predictors of food insecurity among people living with and without HIV in the African Cohort Study

Cecilia C Onyenakie  1   2 , Raphael U Nnakwe  1   2 , Nicole Dear  2   3 , Allahna Esber  2   3 , Emmanuel Bahemana  2   4 , Hannah Kibuuka  5 , Jonah Maswai  2   6 , John Owuoth  7   8 , Trevor A Crowell  2   3 , Christina S Polyak  2   3 , Julie A Ake  2 , Michael Iroezindu  1   2 ; AFRICOS Study Group
Affiliations

Prevalence and predictors of food insecurity among people living with and without HIV in the African Cohort Study

Cecilia C Onyenakie et al. Public Health Nutr. 2022 Apr.

Abstract

Objective: We determined the prevalence and identified predictors of food insecurity in four African countries.

Design: Cross-sectional analyses at study enrolment.

Setting: From January 2013 to March 2020, people living with HIV (PLWH) and without HIV were enrolled at twelve clinics in Kenya, Uganda, Tanzania and Nigeria.

Participants: Participants reporting not having enough food to eat over the past 12 months or receiving <3 meals/d were defined as food insecure. Robust Poisson regression models were used to estimate unadjusted and adjusted prevalence ratios (aPR) and 95 % CI for predictors of food insecurity among all participants and separately among PLWH.

Results: 1694/3496 participants (48·5 %) reported food insecurity at enrolment, with no difference by HIV status. Food insecurity was more common among older participants (50+ v. 18-24 years aPR 1·35, 95 % CI 1·15, 1·59). Having 2-5 (aPR 1·14, 95 % CI 1·01, 1·30) or >5 dependents (aPR 1·17, 95 % CI 1·02, 1·35), and residing in Kisumu West, Kenya (aPR 1·63, 95 % CI 1·42, 1·87) or Nigeria (aPR 1·20, 95 % CI 1·01, 1·41) was associated with food insecurity. Residing in Tanzania (aPR 0·65, 95 % CI 0·53, 0·80) and increasing education (secondary/above education v. none/some primary education aPR 0·73, 95 % CI 0·66, 0·81) was protective against food insecurity. Antiretroviral therapy (ART)-experienced PLWH were more likely to be food secure irrespective of viral load.

Conclusion: Food insecurity was highly prevalent in our cohort though not significantly associated with HIV. Policies aimed at promoting education, elderly care, ART access in PLWH and financial independence could potentially improve food security in Africa.

Keywords: Africa; Antiretroviral therapy; Food insecurity; Food supply; HIV; Nutrition policy.

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Figures

Fig. 1
Fig. 1
Food security indicators stratified by site in the African Cohort Study
See this image and copyright information in PMC

References

    1. Food and Agriculture Organization (FAO) of the United Nations (2016) Policy Brief: Food Security; available at http://www.fao.org/fileadmin/templates/faoitaly/documents/pdf/pdf_Food_S... (accessed 02 October 2018).
    1. FAO, IFAD, UNICEF, WFP and WHO (2018) The State of food security and nutrition in the World 2018: Building Climate Resilience for Food Security and nutrition; available at http://www.fao.org/3/i9553en/i9553en.pdf (accessed 27 March 2019).
    1. FAO, UN Economic Commission for Africa. (2018) Africa Regional Overview of Food Security and Nutrition: Addressing the Threat from Climate Variability and Extremes; available at https://reliefweb.int/sites/reliefweb.int/files/resources/ca2710en.pdf (accessed 28 October 2020).
    1. Rezende Machado de Sousa L, Saint-Ville A, Samayoa-Figueroa L et al. (2019) Changes in food security in Latin America from 2014 to 2017. Food Sec 11, 503–513.
    1. FAO, UNICEF, WHO, WFFP (2018) Asia and the Pacific Regional Overview of Food Security and Nutrition: Accelerating Progress Towards SDGs; available at https://reliefweb.int/sites/reliefweb.int/files/resources/CA0950EN.pdf (accessed 28 October, 2020).

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