Not Having Food to Eat Linked to Poor HIV Med Adherence, Say Researchers
If your cupboards are bare, there is a greater chance that you will have trouble taking your HIV meds and keeping an undetectable viral load, say the researchers of a new study published in the journal JAIDS, as reported by aidsmap.com. The researchers' findings echo the work and mission of groups like God's Love We Deliver, which believe that food justice and addressing poverty are the keys to ending the HIV epidemic.
A whopping 61% of people who accessed food services through Ryan White Part A in New York City reported food insecurity at two separate assessment sessions, while a further 25% reported food insecurity during at least one of the study's assessment sessions. That means that about 86% of New York City residents with HIV who access food services experience food insecurity.
What does food insecurity mean? In this study, food insecurity meant not having the money to buy food, not having food to eat or not eating for a whole day.
Those who reported food insecurity at both assessments had the highest rate of detectable viral loads (29%) as compared to the rate among those who reported food insecurity once (22%) and those who never reported food insecurity (11%).
In New York City, one in six residents experiences food insecurity every year. People of color and people living in poverty are at high risk for HIV acquisition, treatment failure and food insecurity, making poverty and health a complicated cycle. The study found that a lack of food had a negative impact on one's ability to adhere to HIV meds.
But how do we know that food insecurity contributed to detectable viral loads? What if it is poverty itself that is causing challenges with both nutrition and HIV suppression?
The researchers were able to adjust their analysis for the many factors that compound the complicated web of poverty, food insecurity and HIV treatment success, including lack of access to employment and income, lack of access to stable housing, lack of access to quality education and untreated drug addiction. And they still found that detectable viral load and food insecurity were independently related. They also found a relationship between detectable viral load and unstable housing and having lack of access to income.
"Understanding the relationship between food insecurity and clinical health outcomes among people living with HIV is critical in planning interventions for this population, particularly among the urban poor and marginally housed individuals who are at significant risk for food insecurity," the researchers wrote, according to aidsmap.com.
In an interview with TheBody.com, God's Love We Deliver (GLWD) CEO Karen Pearl pointed to earlier research that showed that adequate nutrition allows CD4 counts and viral load biomarkers to improve and that hospital visits drastically decreased -- which means there are both personal and economic reasons to keep people with HIV well-fed.
Of GLWD's mission, Pearl said, "There's a recognition through the Ryan White program that food and nutrition was key to people benefitting from the doctors' appointments that were being made available, from the antiretrovirals that were being made available -- from all the pieces of care that people get to medically address their HIV."
Participants in the study obtained nutrition services from a host of programs, including communal meals, home delivery, pantry programs and food voucher programs. Every person in the study had used these services at least twice between 2011 and 2013, and had their viral load recorded at least once.