Document Detail


The association between food insecurity and mortality among HIV-infected individuals on HAART.
MedLine Citation:
PMID:  19675463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Food insecurity is increasingly recognized as a barrier to optimal treatment outcomes, but there is little data on this issue. We assessed associations between food insecurity and mortality among HIV-infected antiretroviral therapy-treated individuals in Vancouver, British Columbia, and whether body max index (BMI) modified associations.
METHODS: Individuals were recruited from the British Columbia HIV/AIDS drug treatment program in 1998 and 1999 and were followed until June 2007 for outcomes. Food insecurity was measured with the Radimer/Cornell questionnaire. Cox proportional hazard models were used to determine associations between food insecurity, BMI, and nonaccidental deaths when controlling for confounders.
RESULTS: Among 1119 participants, 536 (48%) were categorized as food insecure and 160 (14%) were categorized as underweight (BMI < 18.5). After a median follow-up time of 8.2 years, 153 individuals (14%) had died from nonaccidental deaths. After controlling for adherence, CD4 counts, and socioeconomic variables, people who were food insecure and underweight were nearly 2 times more likely to die (adjusted hazard ratio = 1.94, 95% confidence interval = 1.10 to 3.40) compared with people who were not food insecure or underweight. There was also a trend toward increased risk of mortality among people who were food insecure and not underweight (adjusted hazard ratio = 1.40, 95% confidence interval = 0.91 to 2.05). In contrast, people who were underweight but food secure were not more likely to die.
CONCLUSIONS: Food insecurity is a risk factor for mortality among antiretroviral therapy-treated individuals in British Columbia, particularly among individuals who are underweight. Innovative approaches to address food insecurity should be incorporated into HIV treatment programs.
Authors:
Sheri D Weiser; Kimberly A Fernandes; Eirikka K Brandson; Viviane D Lima; Aranka Anema; David R Bangsberg; Julio S Montaner; Robert S Hogg
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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:  52     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-28     Completed Date:  2009-11-17     Revised Date:  2013-01-31    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  342-9     Citation Subset:  IM; X    
Affiliation:
Department of Medicine, Positive Health Program, San Francisco General Hospital, University of California San Francisco, San Francisco, CA 94143-1372, USA. sheri.weiser@ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiretroviral Therapy, Highly Active*
British Columbia / epidemiology
Female
Food Supply / statistics & numerical data*
HIV Infections / drug therapy*,  epidemiology,  mortality*
Health Surveys
Humans
Male
Middle Aged
Poverty*
Risk Factors
Thinness
Grant Support
ID/Acronym/Agency:
MH 79713-01/MH/NIMH NIH HHS; R01 MH054907/MH/NIMH NIH HHS; //Canadian Institutes of Health Research

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


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