Document Detail

The social context of food insecurity among persons living with HIV/AIDS in rural Uganda.
MedLine Citation:
PMID:  22019367     Owner:  NLM     Status:  MEDLINE    
HIV/AIDS and food insecurity are two of the leading causes of morbidity and mortality in sub-Saharan Africa, with each heightening the vulnerability to, and worsening the severity of, the other. Less research has focused on the social determinants of food insecurity in resource-limited settings, including social support and HIV-related stigma. In this study, we analyzed data from a cohort of 456 persons from the Uganda AIDS Rural Treatment Outcomes study, an ongoing prospective cohort of persons living with HIV/AIDS (PLWHA) initiating HIV antiretroviral therapy in Mbarara, Uganda. Quarterly data were collected by structured interviews. The primary outcome, food insecurity, was measured with the Household Food Insecurity Access Scale. Key covariates of interest included social support, internalized HIV-related stigma, HIV-related enacted stigma, and disclosure of HIV serostatus. Severe food insecurity was highly prevalent overall (38%) and more prevalent among women than among men. Social support, HIV disclosure, and internalized HIV-related stigma were associated with food insecurity; these associations persisted after adjusting for household wealth, employment status, and other previously identified correlates of food insecurity. The adverse effects of internalized stigma persisted in a lagged specification, and the beneficial effect of social support further persisted after the inclusion of fixed effects. International organizations have increasingly advocated for addressing food insecurity as part of HIV/AIDS programming to improve morbidity and mortality. This study provides quantitative evidence on social determinants of food insecurity among PLWHA in resource-limited settings and suggests points of intervention. These findings also indicate that structural interventions to improve social support and/or decrease HIV-related stigma may also improve the food security of PLWHA.
Alexander C Tsai; David R Bangsberg; Nneka Emenyonu; Jude K Senkungu; Jeffrey N Martin; Sheri D Weiser
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-10-10
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  73     ISSN:  1873-5347     ISO Abbreviation:  Soc Sci Med     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-21     Completed Date:  2012-04-05     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1717-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
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MeSH Terms
Food Supply*
HIV Long-Term Survivors*
Rural Population*
Social Support*
Grant Support
K23 MH-79713/MH/NIMH NIH HHS; K23 MH079713/MH/NIMH NIH HHS; K23 MH079713-01/MH/NIMH NIH HHS; K23 MH079713-03S1/MH/NIMH NIH HHS; K24 MH-087227/MH/NIMH NIH HHS; K24 MH087227/MH/NIMH NIH HHS; K24 MH087227-10/MH/NIMH NIH HHS; MH-79713-03S1/MH/NIMH NIH HHS; P30 AI27763/AI/NIAID NIH HHS; R01 MH-054907/MH/NIMH NIH HHS; R01 MH054907/MH/NIMH NIH HHS; R01 MH054907-18/MH/NIMH NIH HHS

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