TITLE

Food insecurity is associated with poor virologic response among HIV-infected patients receiving antiretroviral medications

AUTHOR(S)
Wang, Emily A.; McGinnis, Kathleen A.; Fiellin, David A.; Goulet, Joseph L.; Bryant, Kendall; Gibert, Cynthia L.; Leaf, David A.; Mattocks, Kristin; Sullivan, Lynn E.; Vogenthaler, Nicholas; Justice, Amy C.; VACS Project Team
PUB. DATE
September 2011
SOURCE
JGIM: Journal of General Internal Medicine;Sep2011, Vol. 26 Issue 9, p1012
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Background and Objective: Food insecurity negatively impacts HIV disease outcomes in international settings. No large scale U.S. studies have investigated the association between food insecurity and severity of HIV disease or the mechanism of this possible association. The objective of this study was to examine the impact of food insecurity on HIV disease outcomes in a large cohort of HIV-infected patients receiving antiretroviral medications.Design: This is a cross-sectional study.Participants and Setting: Participants were HIV-infected patients enrolled in the Veterans Aging Cohort Study between 2002-2008 who were receiving antiretroviral medications.Main Measurements: Participants reporting "concern about having enough food for you or your family in the past 30 days" were defined as food insecure. Using multivariable logistic regression, we explored the association between food insecurity and both low CD4 counts (<200 cells/μL) and unsuppressed HIV-1 RNA (>500 copies/mL). We then performed mediation analysis to examine whether antiretroviral adherence or body mass index mediates the observed associations.Key Results: Among 2353 HIV-infected participants receiving antiretroviral medications, 24% reported food insecurity. In adjusted analyses, food insecure participants were more likely to have an unsuppressed HIV-1 RNA (AOR 1.37, 95% CI 1.09, 1.73) compared to food secure participants. Mediation analysis revealed that neither antiretroviral medication adherence nor body mass index contributes to the association between food insecurity and unsuppressed HIV-1 RNA. Food insecurity was not independently associated with low CD4 counts.Conclusions: Among HIV-infected participants receiving antiretroviral medications, food insecurity is associated with unsuppressed viral load and may render treatment less effective. Longitudinal studies are needed to test the potential causal association between food insecurity, lack of virologic suppression, and additional HIV outcomes.
ACCESSION #
64385050

 

Related Articles

  • Food insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. Weiser, Sheri D.; Frongillo, Edward A.; Ragland, Kathleen; Hogg, Robert S.; Riley, Elise D.; Bangsberg, David R. // JGIM: Journal of General Internal Medicine;Jan2009, Vol. 24 Issue 1, p14 

    Background and Objectives: There is growing international concern that food insecurity may negatively impact antiretroviral (ARV) treatment outcomes, but no studies have directly evaluated the effect of food insecurity on viral load suppression and antiretroviral adherence. We...

  • Is the quality of the patient-provider relationship associated with better adherence and health outcomes for patients with HIV? Beach, Mary Catherine; Keruly, Jeanne; Moore, Richard D. // JGIM: Journal of General Internal Medicine;Jun2006, Vol. 21 Issue 6, p661 

    PURPOSE: Patient-centeredness, originally defined as understanding each patient as a unique person, is widely considered the standard for high-quality interpersonal care. The purpose of our study was to examine the association between patient perception of being ‘known as a person’...

  • Is patients' preferred involvement in health decisions related to outcomes for patients with HIV? Beach, Mary Catherine; Duggan, Patrick S.; Moore, Richard O.; Moore, Richard D // JGIM: Journal of General Internal Medicine;Aug2007, Vol. 22 Issue 8, p1119 

    Background: Previous studies suggest that patients who are more involved in their medical care have better outcomes.Objectives: We sought to compare health care processes and outcomes for patients with HIV based on their preferred level of involvement in health...

  • Treatment outcomes and cost-effectiveness of shifting management of stable ART patients to nurses in South Africa: an observational cohort. Long, Lawrence; Brennan, Alana; Fox, Matthew P.; Ndibongo, Buyiswa; Jaffray, Imogen; Sanne, Ian; Rosen, Sydney // PLoS Medicine;Jul2011, Vol. 8 Issue 7, p1 

    Background: To address human resource and infrastructure shortages, resource-constrained countries are being encouraged to shift HIV care to lesser trained care providers and lower level health care facilities. This study evaluated the cost-effectiveness of down-referring stable...

  • ADHERENCE TO ANTIRETROVIRAL THERAPY: A CROSS-SECTIONAL STUDY OF ADULTS IN ETHIOPIA. Zeleke, A. B.; Thupayagale-Tshweneagae, G. B. // Africa Journal of Nursing & Midwifery;2013, Vol. 15 Issue 2, p101 

    Antiretroviral medications have improved the management of the Human Immunodeficiency Virus infection. However, their effectiveness in suppressing the replication of the human immunodeficiency virus is hampered by adherence levels below 95%. This study examined the influences on the use of...

  • Effects of drug abuse and mental disorders on use and type of antiretroviral therapy in HIV-infected persons. Turner, Barbara J.; Fleishman, John A.; Wenger, Neil; London, Andrew S.; Burnam, M. Audrey; Shapiro, Martin F.; Bing, Eric G.; Stein, Michael D.; Longshore, Douglas; Bozzette, Samuel A.; Turner, B J; Fleishman, J A; Wenger, N; London, A S; Burnam, M A; Shapiro, M F; Bing, E G; Stein, M D; Longshore, D; Bozzette, S A // JGIM: Journal of General Internal Medicine;Sep2001, Vol. 16 Issue 9, p625 

    Objective: To distinguish the effects of drug abuse, mental disorders, and problem drinking on antiretroviral therapy (ART) and highly active ART (HAART) use.Design: Prospective population-based probability sample of 2,267 (representing 213,308) HIV-infected persons in...

  • HIV testing of at risk patients in a large integrated health care system. Owens, Douglas K.; Sundaram, Vandana; Lazzeroni, Laura C.; Douglass, Lena R.; Tempio, Patricia; Holodniy, Mark; Sanders, Gillian D.; Shadle, Vera M.; McWhorter, Valerie C.; Agoncillo, Teodora; Haren, Noreen; Chavis, Darlene; Borowsky, Leila H.; Yano, Elizabeth M.; Jensen, Peter; Simberkoff, Michael S.; Bozzette, Samuel A. // JGIM: Journal of General Internal Medicine;Mar2007, Vol. 22 Issue 3, p315 

    Objective: Early identification of HIV infection is critical for patients to receive life-prolonging treatment and risk-reduction counseling. Understanding HIV screening practices and barriers to HIV testing is an important prelude to designing successful HIV screening programs. Our...

  • Adherence to antiretroviral therapy assessed by unannounced pill counts conducted by telephone. Kalichman, Seth C.; Amaral, Christina M.; Stearns, Heidi; White, Denise; Flanagan, Jody; Pope, Howard; Cherry, Chauncey; Cain, Demetria; Eaton, Lisa; Kalichman, Moira O. // JGIM: Journal of General Internal Medicine;Jul2007, Vol. 22 Issue 7, p1003 

    Background: Unannounced pill counts conducted in patients' homes is a valid objective method for monitoring medication adherence that is unfortunately costly and often impractical. Conducting unannounced pill counts by telephone may be a viable alternative for objectively assessing...

  • A Measurement Model of Medication Adherence to Highly Active Antiretroviral Therapy and Its Relation to Viral Load in HIV-Positive Adults. Llabre, Maria M.; Weaver, Kathryn E.; Durán, Ron E.; Antoni, Michael H.; McPherson-Baker, Shvawn; Schneiderman, Neil // AIDS Patient Care & STDs;Oct2006, Vol. 20 Issue 10, p701 

    This study compared a multiple method measurement model of highly active antiretroviral therapy (HAART) adherence with single-method models to determine optimal validity in predicting HIV viral load. Repeated measures of antiretroviral adherence were collected over a 15-month period using three...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics