Association Between Food Insecurity and HIV Viral Suppression: A Systematic Review and Meta-Analysis

Abstract

Although an increasing number of HIV infected people are accessing antiretroviral treatment, many do not achieve complete HIV viral suppression and remain at risk for AIDS and capable of HIV transmission. Food insecurity has been identified as a potential risk factor for poor virologic response, but the association between these factors has been inconsistently documented in the literature. We systematically searched five electronic databases and bibliographies of relevant studies through April 2015 and retrieved 11 studies that met our inclusion criteria, of which nine studies were conducted in North America and the remaining two studies were in Brazil and Uganda respectively. Meta-analyzed results indicated that experiencing food insecurity resulted in 29% lower odds of achieving complete HIV viral suppression (OR = 0.71, 95% CI 0.61-0.82) and this significant inverse association was consistently found regardless of study design, exposure measurement, and confounder adjustment methods. These findings suggest that food insecurity is a potential risk factor for incomplete HIV viral suppression in people living with HIV.

Food security in a sample of clients attending HIV clinics in New South Wales: A cross‐sectional study

“…FI has been identified as an increasing issue in Sydney previously and this study provided up to date information on the current issue. The findings in this study were higher than in 2007 and marginally lower than in 2009, being 31% in 2007, 53% in 2009 and 47% in 2016 . It was not unexpected to find that PLHIV in Sydney who were food insecure had higher rates of unemployment and perceived their health as poor or fair.…”

“…Variables were grouped into two groups to complete the significance statistical tests and odds ratio. Employment status was grouped as either employed or unemployed, education level was classified as completing final year of secondary school and higher versus lower than completing final year of secondary school and CD4 t cell count was grouped as less than 500 and 500 cells/mm 3 Bivariate analysis was conducted to investigate differences between variables for those who were food secure and food insecure. Analysis of descriptive and frequency statistics from the demographic questionnaire and the prevalence of FI is shown in summary in Table 1.…”

“…FI of PLHIV in Sydney was studied in 2007 and 2009. In 2007, they found of the 196 PLHIV, the prevalence of FI with hunger was 21%, FI without hunger was 10% (total 31%) and food security was 69% . In 2009, of 304 PLHIV 53% reported some form of FI.…”

“…In 2007, they found of the 196 PLHIV, the prevalence of FI with hunger was 21%, FI without hunger was 10% (total 31%) and food security was 69%. 3 In 2009, of 304 PLHIV 53% reported some form of FI. It was also seen that respondents on a pension were more likely to have FI than those receiving other sources of income.…”

The effect of gender on food insecurity among HIV-infected people receiving anti-retroviral therapy: A systematic review and meta-analysis

“…For example, food insecurity defined as having uncertain or limited availability of nutritionally adequate or safe food or the inability to procure food in socially acceptable ways has been identified as the critical contributing factor for poor health outcome among adults living with HIV[3–6]. In addition to harming immunological and clinical outcomes in HIV-infected individuals, food insecurity has also been shown to increase the risk of HIV exposure and infection [7].…”