Role of Antiretroviral Therapy in Improving Food Security Among Patients Initiating HIV Treatment and Care

Published in: AIDS, v. 26, no. 18, Nov. 2012, p. 2375-2381

Posted on RAND.org on November 01, 2012

by Kartika Palar, Glenn Wagner, Bonnie Ghosh-Dastidar, Peter Mugyenyi

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Research Question

  1. How does HIV antiretroviral therapy (ART) affect food security of adults with HIV?

OBJECTIVE: Although the physical health benefits of HIV antiretroviral therapy (ART) are well documented, the socioeconomic benefits are still being established. Few studies have examined the effects of ART on food insecurity, although studies suggest there may be a benefit via improved health and ability to work. DESIGN: Twelve-month prospective cohort study of 602 treatment-naive patients initiating clinical care in Uganda. METHODS: Longitudinal multivariate logistic regression was used to investigate the effect of ART on food insecurity compared to HIV care without ART. A staged regression approach was used to explore pathways through which ART may affect food insecurity. RESULTS: Food insecurity decreased significantly for both the ART and non-ART groups over time, with the ART group experiencing greater reductions by the end of the study. ART remained a significant predictor of reduction in food insecurity over time after controlling for baseline differences in the regression model (odds ratio 0.642; P < 0.01). Improvements in work and mental health status were identified as potential pathways through which ART may improve food security. CONCLUSION: Taken together with the well known benefits of food security on ART adherence, treatment retention and clinical outcomes in resource-poor settings, our results suggest that a positive feedback loop of improved functioning and productivity could result from the interaction between food security and ART. Policymakers could leverage this positive cycle by strengthening mental health support and promoting sustainable food security interventions as part of HIV treatment programs.

Key Findings

  • HIV antiretroviral therapy (ART) helps alleviate the food insecurity of adults with HIV.
  • Reducing food insecurity may improve ART outcomes.

Recommendation

  • Policymakers could leverage this positive cycle by strengthening mental health support and promoting sustainable food security programs as part of HIV treatment.

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