Access to adequate nutrition is a major potential obstacle to antiretroviral adherence among HIV-infected individuals in Rwanda

Au, Joyce T.; Kayitenkore, Kayitesi; Shutes, Erin; Karita, Etienne; Peters, Philip J.; Tichacek, Amanda; Allen, Susan

doi:10.1097/01.aids.0000247580.16073.1b

Cited by 105 publications

(103 citation statements)

References 15 publications

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“…This association has fostered a great deal of interest because of the links between poor adherence and HIV suppression, immunological decline and the progression of HIV to AIDS . A growing number of studies have demonstrated or at least called attention to the important links between food insecurity and ART initiation, adherence, and consistency of ARV consumption (see, e.g., Au et al, 2006;Nachega et al, 2006;Hardon et al, 2007;Olupot-Olupot et al, 2008;Sanjobo et al, 2008;Kalofonos, 2010). In each of these studies, food concerns took on different dimensions.…”

Section: Food Insecurity and Hiv/aidsmentioning

confidence: 99%

Coping and the biosocial consequences of food insecurity in the 21st century

Hadley

Crooks

2012

American J Phys Anthropol

123

108

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Food security occurs when all members of a household have reliable access to food in sufficient quantity and quality to maintain an active and healthy lifestyle. Given the important biological and social value of food for humans, food and food sufficiency have been traditional topics of study among biological anthropologists. The focus on food insecurity, however, has emerged within the past two decades and recent global events, including the food crisis of 2007/2008, have led to renewed interests in the topic of food insecurity and wellbeing. Here, we review current and novel threats to food security, current thinking on measurement and definitions, and then outline a model that links food insecurity to coping strategies and then to health outcomes. We suggest that coping strategies are typically context-specific and can be food and nonfood based. We further suggest that coping strategies may impact health quite broadly, not just through nutritional pathways. We then review available data on the relationship between food insecurity and nutritional status, chronic diseases, infectious diseases, and mental health. Our review highlights the far reaching consequences of food insecurity for human wellbeing but also the considerable variability in its effect and our limited empirical knowledge of the pathways through which food insecurity impacts health. We conclude by offering thoughts on how biological anthropologists might contribute to growing our understanding of food insecurity and human health and wellbeing. Yrbk Phys Anthropol 55:72-94, 2012. V

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Section: Food Insecurity and Hiv/aidsmentioning

confidence: 99%

Coping and the biosocial consequences of food insecurity in the 21st century

Hadley

Crooks

2012

American J Phys Anthropol

123

108

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“…The following set of twelve food groups was used to calculate the IDDS: (i) cereals; (ii) roots and tubers; (iii) pulses and legumes/nuts; (iv) vegetables; (v) fruits; (vi) meat and poultry; (vii) eggs; (viii) fish and seafood; (ix) milk and milk products; (x) oils and fats; (xi) sugar and sweets; and (xii) condiments and miscellaneous. Three categories of dietary diversity were created, based on IDDS: (i) low (0-4), (ii) medium (5-8) and (iii) high (9)(10)(11)(12).…”

Section: Individual Diet Qualitymentioning

confidence: 99%

Food access and diet quality independently predict nutritional status among people living with HIV in Uganda

Kadiyala

Raj

2012

Public Health Nutr.

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Objective: Although undernutrition is recognized as a risk factor for mortality among people living with HIV (PLWHIV), even among those initiating antiretroviral therapy, few studies have explored the underlying determinants of undernutrition. The objectives of the present study were to: (i) examine the independent association between household food security, individual diet quality and nutritional status; and (ii) determine if any association between food security and nutritional status is mediated through diet quality. Design: Cross-sectional baseline survey. Setting: Gulu and Soroti districts, Uganda. Subjects: Nine hundred and two PLWHIV recruited into a study evaluating the impact of a food assistance programme supported by the World Food Programme. Results: Food security and diet quality were measured using the Household Food Insecurity Access Scale (HFIAS) and the Individual Dietary Diversity Score (IDDS), respectively. Multivariate regression results demonstrated that HFIAS and IDDS independently predict BMI (P , 0?01) and mid upper-arm circumference (P , 0?05). The adjusted odds ratio of being underweight (BMI , 18?5 kg/m 2 ) among individuals living in severely food-insecure households was 1?92 (P , 0?0 0 1); individuals consuming a highly diverse diet had an adjusted odds ratio of being underweight of 0?56 (P , 0?05) compared with those consuming a diet of low diversity. Similar results were observed when mid upper-arm circumference and wasting were modelled as outcomes. Using path analysis, we observed that the indirect effect of food insecurity on BMI mediated through dietary diversity is negligible, and mostly a result of the direct effect of food insecurity on BMI. Conclusions: Our results provide an empirical basis for focused efforts on improving food access and diet quality among PLWHIV. Addressing the broader structural determinants of food security of people infected and affected by HIV is crucial.

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“…Food insecurity is one of the multiple barriers that individuals face in initiating and adhering to long-term medical therapies such as ART and DOTS, especially in resourcelimited settings [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Other patient-related barriers include the complexity of the medication regimen [18], emotional distress [7], illness costs to households [19], stigma [20], health beliefs and poverty [4], limited knowledge of the disease [21], difficulty remembering [22], intentional non-adherence due to adverse drug reactions [23] and harmful use of alcohol [24].…”

Section: Introductionmentioning

confidence: 99%

“…Adherence support strategies may include directly observed treatment, education and counseling, patient reminder and late patient tracer systems, and incentive or enabler 1 systems, including food assistance. It is important to note that food assistance often has a dual role.…”

Section: Introductionmentioning

confidence: 99%

The Enabling Effect of Food Assistance in Improving Adherence and/or Treatment Completion for Antiretroviral Therapy and Tuberculosis Treatment: A Literature Review

et al. 2014

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Socioeconomic costs of HIV and TB and the difficulty of maintaining optimal treatment are well documented. Social protection measures such as food assistance may be required to offset some of the treatment related costs as well as to ensure food security and maintain good health of the affected individual and household. Programmes have started placing greater emphasis on treatment adherence and are looking for proven interventions that can optimize it. This paper looks at the effect of food assistance for enabling treatment adherence and reviews studies that used food assistance to promote adherence. Eight of ten studies found that provision of food can improve adherence and/or treatment completion for HIV care and treatment, ART and TB-DOTS. This indicates that food provision is not only a biological, but also a behavioural intervention, and underscores that unresolved food insecurity can be an impediment to treatment adherence and consequently to good treatment outcomes.

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Access to adequate nutrition is a major potential obstacle to antiretroviral adherence among HIV-infected individuals in Rwanda

Cited by 105 publications

References 15 publications

Coping and the biosocial consequences of food insecurity in the 21st century

Coping and the biosocial consequences of food insecurity in the 21st century

Food access and diet quality independently predict nutritional status among people living with HIV in Uganda

The Enabling Effect of Food Assistance in Improving Adherence and/or Treatment Completion for Antiretroviral Therapy and Tuberculosis Treatment: A Literature Review

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