Document Detail


Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda.
MedLine Citation:
PMID:  22692093     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether time on antiretroviral therapy (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status.
DESIGN: The Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda.
METHODS: Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each 3-month period. Outcomes were food insecurity, nutritional status, and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and sociodemographic characteristics.
RESULTS: Two hundred twenty-eight ART-naive participants were followed for up to 3 years, and 41% were severely food insecure at baseline. The mean food insecurity score progressively declined (test for linear trend P < 0.0001), beginning with the second quarter (b = -1.6; 95% confidence interval: -2.7 to -0.45) and ending with the final quarter (b = -6.4; 95% confidence interval: -10.3 to -2.5). PHS and nutritional status improved in a linear fashion over study follow-up (P < 0.001). Inclusion of PHS in the regression model attenuated the relationship between ART duration and food security.
CONCLUSIONS: Among HIV-infected individuals in Uganda, food insecurity decreased and nutritional status and PHS improved over time after initiation of ART. Changes in food insecurity were partially explained by improvements in PHS. These data support early initiation of ART in resource-poor settings before decline in functional status to prevent worsening food insecurity and its detrimental effects on HIV treatment outcomes.
Authors:
Sheri D Weiser; Reshma Gupta; Alexander C Tsai; Edward A Frongillo; Nils Grede; Elias Kumbakumba; Annet Kawuma; Peter W Hunt; Jeffrey N Martin; David R Bangsberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  61     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-25     Completed Date:  2012-12-04     Revised Date:  2014-03-12    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  179-86     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active*
Blood Chemical Analysis
Feeding Behavior*
HIV Infections / drug therapy*
Health Status*
Humans
Interviews as Topic
Male
Nutritional Status*
Physical Fitness*
Rural Population
Time Factors
Treatment Outcome
Uganda
Grant Support
ID/Acronym/Agency:
K23 MH079713/MH/NIMH NIH HHS; K23 MH079713/MH/NIMH NIH HHS; K24 MH087227/MH/NIMH NIH HHS; K24 MH87227/MH/NIMH NIH HHS; MH79713-03S1/MH/NIMH NIH HHS; P30 AI060354/AI/NIAID NIH HHS; P30 AI27763/AI/NIAID NIH HHS; R01 MH054907/MH/NIMH NIH HHS; R01 MH54907/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents
Comments/Corrections

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