Document Detail


Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting.
MedLine Citation:
PMID:  21904186     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We undertook a longitudinal study in rural Uganda to understand the association of food insecurity with morbidity and patterns of healthcare utilization among HIV-infected individuals enrolled in an antiretroviral therapy program.
DESIGN: Longitudinal cohort study.
METHODS: Participants were enrolled from the Uganda AIDS Rural Treatment Outcomes cohort, and underwent quarterly structured interviews and blood draws. The primary predictor was food insecurity measured by the validated Household Food Insecurity Access Scale. Primary outcomes included health-related quality of life measured by the validated Medical Outcomes Study-HIV Physical Health Summary (PHS), incident self-reported opportunistic infections, number of hospitalizations, and missed clinic visits. To estimate model parameters, we used the method of generalized estimating equations, adjusting for sociodemographic and clinical variables. Explanatory variables were lagged by 3 months to strengthen causal interpretations.
RESULTS: Beginning in May 2007, 458 persons were followed for a median of 2.07 years, and 40% were severely food insecure at baseline. Severe food insecurity was associated with worse PHS, opportunistic infections, and increased hospitalizations (results were similar in concurrent and lagged models). Mild/moderate food insecurity was associated with missed clinic visits in concurrent models, whereas in lagged models, severe food insecurity was associated with reduced odds of missed clinic visits.
CONCLUSION: Based on the negative impact of food insecurity on morbidity and patterns of healthcare utilization among HIV-infected individuals, policies and programs that address food insecurity should be a critical component of HIV treatment programs worldwide.
Authors:
Sheri D Weiser; Alexander C Tsai; Reshma Gupta; Edward A Frongillo; Annet Kawuma; Jude Senkungu; Peter W Hunt; Nneka I Emenyonu; Jennifer E Mattson; 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:  AIDS (London, England)     Volume:  26     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-11-30     Completed Date:  2012-02-24     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  67-75     Citation Subset:  IM; X    
Affiliation:
Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, 94143, USA. Sheri.Weiser@ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / drug therapy,  economics*,  epidemiology
Adult
Cohort Studies
Delivery of Health Care / utilization*
Female
Food Supply / economics*
HIV Infections / drug therapy,  economics*,  epidemiology*
HIV-1 / isolation & purification*
Hospitalization / economics*
Humans
Longitudinal Studies
Male
Morbidity
Patient Compliance
Quality of Life
Questionnaires
RNA, Viral / isolation & purification
Rural Health
Socioeconomic Factors
Uganda / epidemiology
Viral Load
Grant Support
ID/Acronym/Agency:
K23 MH079713/MH/NIMH NIH HHS; K24 MH087227/MH/NIMH NIH HHS; K24 MH087227/MH/NIMH NIH HHS; MH-79713-03S1/MH/NIMH NIH HHS; P30 AI027793/AI/NIAID NIH HHS; R01 MH054907/MH/NIMH NIH HHS; R01 MH054907/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/RNA, Viral
Comments/Corrections
Comment In:
AIDS. 2012 Jan 2;26(1):115-7   [PMID:  22126815 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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