Adherence to antiretroviral therapy among a conflict-affected population in Northeastern Uganda: a qualitative study

Katawera, Andrew; Cooper, Curtis; Small, Will; Anema, Aranka; Mills, Edward

doi:10.1097/qad.0b013e3283112ba6

Cited by 38 publications

(28 citation statements)

References 3 publications

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“…Among low-income adults, food insecurity and other competing subsistence needs (eg, unstable housing) are associated with worsened access and adherence to care (151)(152)(153)(154) because competing subsistence priorities such as obtaining food and shelter often interfere with adherence to regular medication use or attendance at outpatient appointments (15,(155)(156)(157)(158)(159)(160)(161)(162)(163). Research on adherence to other long-term medication regimens, such as tuberculosis, has also indicated the importance of food security to adherence and treatment outcomes (164,165).…”

Section: Behavioral Pathwaysmentioning

confidence: 99%

Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS

Weiser

Young

Cohen

et al. 2011

The American Journal of Clinical Nutrition

388

427

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Food insecurity, which affects >1 billion people worldwide, is inextricably linked to the HIV epidemic. We present a conceptual framework of the multiple pathways through which food insecurity and HIV/AIDS may be linked at the community, household, and individual levels. Whereas the mechanisms through which HIV/AIDS can cause food insecurity have been fairly well elucidated, the ways in which food insecurity can lead to HIV are less well understood. We argue that there are nutritional, mental health, and behavioral pathways through which food insecurity leads to HIV acquisition and disease progression. Specifically, food insecurity can lead to macronutrient and micronutrient deficiencies, which can affect both vertical and horizontal transmission of HIV, and can also contribute to immunologic decline and increased morbidity and mortality among those already infected. Food insecurity can have mental health consequences, such as depression and increased drug abuse, which, in turn, contribute to HIV transmission risk and incomplete HIV viral load suppression, increased probability of AIDS-defining illness, and AIDS-related mortality among HIV-infected individuals. As a result of the inability to procure food in socially or personally acceptable ways, food insecurity also contributes to risky sexual practices and enhanced HIV transmission, as well as to antiretroviral therapy nonadherence, treatment interruptions, and missed clinic visits, which are strong determinants of worse HIV health outcomes. More research on the relative importance of each of these pathways is warranted because effective interventions to reduce food insecurity and HIV depend on a rigorous understanding of these multifaceted relationships.

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Section: Behavioral Pathwaysmentioning

confidence: 99%

Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS

Weiser

Young

Cohen

et al. 2011

The American Journal of Clinical Nutrition

388

427

View full text Add to dashboard Cite

show abstract

“…In contrast, thoughts about drug toxicities, disruption of the daily routine, and acceptance of their HIV illness were of concern to only a minority of participants [13]. In a conflict-affected population in northeastern Uganda, individuals consuming only one meal a day and those dependant on caregivers for food were particularly prone to missing ART doses [52]. In Zambia, the belief that antiretrovirals must be taken with food has led individuals to skip doses in the absence of available or accessible food [53].…”

Section: Impact Of Food Insecurity On Hiv Treatment and Clinical Outcmentioning

confidence: 99%

Food insecurity and HIV/AIDS: Current knowledge, gaps, and research priorities

Anema¹,

Vogenthaler²,

Frongillo³

et al. 2009

Curr HIV/AIDS Rep

Self Cite

274

241

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Food insecurity and HIV/AIDS are intertwined in a vicious cycle that heightens vulnerability to, and worsens the severity of, each condition. We review current knowledge and research priorities regarding the impact of food insecurity on HIV transmission risk and clinical outcomes. Observational studies suggest that food insecurity is associated with increased HIV transmission risk behaviors and decreased access to HIV treatment and care. Among individuals receiving antiretroviral therapy (ART), food insecurity is associated with decreased ART adherence, reduced baseline CD4 cell count, incomplete virologic suppression, and decreased survival. Integration of food security interventions into HIV/AIDS treatment programs is essential to curtail the HIV/AIDS epidemic and improve health and quality of life among those infected. Longitudinal research applying validated measurement tools is needed to better understand the mechanisms through which food insecurity adversely impacts HIV transmission, treatment, and care. Research should compare the effectiveness of various food assistance and livelihood strategies.

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“…This association has fostered a great deal of interest because of the links between poor adherence and HIV suppression, immunological decline and the progression of HIV to AIDS . A growing number of studies have demonstrated or at least called attention to the important links between food insecurity and ART initiation, adherence, and consistency of ARV consumption (see, e.g., Au et al, 2006;Nachega et al, 2006;Hardon et al, 2007;Olupot-Olupot et al, 2008;Sanjobo et al, 2008;Kalofonos, 2010). In each of these studies, food concerns took on different dimensions.…”

Section: Food Insecurity and Hiv/aidsmentioning

confidence: 99%

Coping and the biosocial consequences of food insecurity in the 21st century

Hadley

Crooks

2012

American J Phys Anthropol

128

108

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Food security occurs when all members of a household have reliable access to food in sufficient quantity and quality to maintain an active and healthy lifestyle. Given the important biological and social value of food for humans, food and food sufficiency have been traditional topics of study among biological anthropologists. The focus on food insecurity, however, has emerged within the past two decades and recent global events, including the food crisis of 2007/2008, have led to renewed interests in the topic of food insecurity and wellbeing. Here, we review current and novel threats to food security, current thinking on measurement and definitions, and then outline a model that links food insecurity to coping strategies and then to health outcomes. We suggest that coping strategies are typically context-specific and can be food and nonfood based. We further suggest that coping strategies may impact health quite broadly, not just through nutritional pathways. We then review available data on the relationship between food insecurity and nutritional status, chronic diseases, infectious diseases, and mental health. Our review highlights the far reaching consequences of food insecurity for human wellbeing but also the considerable variability in its effect and our limited empirical knowledge of the pathways through which food insecurity impacts health. We conclude by offering thoughts on how biological anthropologists might contribute to growing our understanding of food insecurity and human health and wellbeing. Yrbk Phys Anthropol 55:72-94, 2012. V

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Adherence to antiretroviral therapy among a conflict-affected population in Northeastern Uganda: a qualitative study

Cited by 38 publications

References 3 publications

Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS

Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS

Food insecurity and HIV/AIDS: Current knowledge, gaps, and research priorities

Coping and the biosocial consequences of food insecurity in the 21st century

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