Frequent food insecurity among injection drug users: correlates and concerns

Abstract

BackgroundFood insecurity and nutrition are two topics that are under-researched among injection drug users (IDUs). Our study examined the extent and correlates of food insecurity among a sample of IDUs and explored whether there is an association between food insecurity and injection-related HIV risk.MethodsA cross-sectional survey was conducted using interviewer-administered questionnaires. Data were collected at a needle exchange program in London, Ontario, Canada between September 2006 and January 2007. Participants included 144 English-speaking IDUs who had injected drugs in the past 30 days. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, food insecurity, and health/social service use.ResultsIn the past 6 months, 54.5% of participants reported that on a daily/weekly basis they did not have enough to eat because of a lack of money, while 22.1% reported this type of food insecurity on a monthly basis. Moreover, 60.4% and 24.3% reported that they did not eat the quality or quantity of food they wanted on a daily/weekly or a monthly basis, respectively. Participants reported re-using someone else’s injection equipment: 21% re-used a needle, 19% re-used water, and 37.3% re-used a cooker. The odds of sharing injection equipment were increased for food insecure individuals.ConclusionsFindings show that IDUs have frequent and variable experiences of food insecurity and these experiences are strongly correlated with sharing of injection-related equipment. Such behaviours may increase the likelihood of HIV and HCV transmission in this population. Addressing food-related needs among IDUs is urgently needed.

Food insecurity among people who inject drugs in Los Angeles and San Francisco

“…Other studies have reported that PWID often eat fewer meals or skip meals for an entire day due to binge drug use (12,19) and this may explain the overall high level of food insecurity in our PWID population as well. Not only is overall dietary intake lower, diet composition is often significantly different among drug users.…”

“…Our study is consistent with previous research that found exceedingly high levels of food insecurity among people who use drugs, PWID and HIV-positive individuals, although use of alternative methods to establish food insecurity prevalence prevents making direct comparisons. In a Vancouver-based study, 64·7 % of PWID self-reported to be currently hungry due to a lack of money (9) ; and 54·5 % of PWID in London, Ontario reported not having enough to eat because of a lack of money (12) . Similarly, about half (53·6 %) of an HIV-positive population of adults living in poverty in San Francisco were food insecure based on the nine-question Household Food Insecurity Access Scale used primarily in international settings (18) .…”

“…In the adjusted, final model we found that only indirect syringe exchange use was associated with food insecurity. A Canadian study found associations of unsafe injection practices with food insecurity (12) . It is possible that not directly using syringe exchange services and concern with arrest for drug paraphernalia indicated an elevated fear of exposure as a PWID.…”

“…One study found that 65 % of PWID in urban Canada reported difficulty affording enough food and feeling hungry as a result (9) . However, that study relied on a single question for estimating hunger (9) , a modified measure specific to Canada (12) . Research on the vulnerable intersection between hunger and injection drug use representing areas outside North America is lacking.…”

Food Insecurity and Depressive Symptoms: Comparison of Drug Using and Nondrug‐using Women at Risk for Hiv

“…Himmelgreen and researchers (1998) found that female drug users were more likely to experience food insecurity and have poor nutritional status compared to non-drug using women. Likewise, Strike and colleagues (2012) reported high levels of food insecurity among injection drug users. Further, food insecurity among drug users has been linked to risky sex and injection behaviors (Shannon et al, 2011; Strike et al, 2012).…”