Adherence to HIV and TB Care and Treatment, the Role of Food Security and Nutrition

Claros, Joan M.; Pee, Saskia de; Bloem, Martin W.

doi:10.1007/s10461-014-0870-4

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…The African Food Security Network (AFSUN) 2008–2009 survey of patients with HIV/TB in 11 southern African cities showed that only 10% of patients with TB resided in food-secure households [ 35 ]. Food insecurity increases the risk of progression from latent to active disease, is a risk factor for infection, and can negatively impact on adherence [ 36 ]. A qualitative study in Swaziland found that some food-insecure patients stopped TB treatment because it increased their appetites when they were already food scarce [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“I’m suffering for food”: Food insecurity and access to social protection for TB patients and their households in Cape Town, South Africa

2022

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Background Tuberculosis (TB) is a major health concern and the number one cause of death in South Africa. Social protection programmes can strengthen the resilience of TB patients, their families and households. This study aimed to get a better understanding of the role of social protection and other forms of support in relation to the burden of TB on patients and their households in South Africa. Methods This is a cross-sectional exploratory qualitative study using a phenomenological approach to focus on the lived experiences and perceptions of TB patients and healthcare workers. We interviewed 16 patients and six healthcare workers and analysed data thematically. Results The challenges faced by participants were closely related to household challenges. Participants reported a heavy physical burden, aggravated by a lack of nutritious food and that households could not provide the food they needed. Some needed to resort to charity. At the same time, households were significantly affected by the burden of caring for the patient—and remained the main source of financial, emotional and physical support. Participants reported challenges and costs associated with the application process and high levels of discretion by the assessing doctor allowing doctors’ opinions and beliefs to influence their assessment. Conclusion Access to adequate nutritious food was a key issue for many patients and this need strained already stretched households and budgets. Few participants reported obtaining state social protection support during their illness, but many reported challenges and high costs of trying to access it. Further research should be conducted on support mechanisms and interventions for TB patients, but also their households, including food support, social protection and contact tracing. In deciding eligibility for grants, the situation of the household should be considered in addition to the individual patient.

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Section: Discussionmentioning

confidence: 99%

“I’m suffering for food”: Food insecurity and access to social protection for TB patients and their households in Cape Town, South Africa

2022

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“…Food insecurity has been associated with distress, depression, and anxiety (33–35,54–56). This may be a plausible explanation to the lack of adherence to treatment observed among food insecure HIV infected adults when compared to their food secure counterparts (32, 57). Previous evidence points in part, to psychological stress as a factor for reduced adherence to treatment among PLHIV (58, 59).…”

Section: Discussionmentioning

confidence: 99%

Food Security Status is Related to Mental Health Quality of Life Among Persons Living with HIV

2016

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This study evaluated the association between health related quality of life and food security among persons living with HIV (PLHIV). We studied 167 PLHIV who completed questionnaires assessing food security, disease symptomatology, and several domains of the SF-36 health related quality of life survey. HIV disease state was assessed from medical records. Associations between independent and outcome variables were determined through linear regression models. Compared to food security, very low food security was significantly associated with lower mental component summary scores, [average difference: −4.98 (95% CI: −9.85, −0.10; mental health, [average difference: −5.44 (95% CI: −10.08, −0.81); and general health, [average difference: −5.13 (95% CI: −9.65, −0.65)] after adjusting for covariates. About a fourth of participants experienced severe food insecurity, which negatively influenced their mental health and general wellbeing. The inclusion of resources for food assistance in HIV treatment programs may help ameliorate mental health challenges faced by PLHIV.

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“…Employing a synergistic epidemic lens via the syndemics framework, food insecurity coexists and overlaps with the significant prevalence of HIV/AIDS in various regions in Africa. PWH experiencing food insecurity are likely to experience hunger, coupled with the side effects of ART, in the context of competing resources, which could increase the chances of treatment non-adherence [13]. In the context of food insecurity, evidence shows that HIV is a strong predictor of malnutrition, potentially increasing vulnerability to other comorbidities such as tuberculosis (TB) [14].…”

Section: Introductionmentioning

confidence: 99%

HIV, Tuberculosis, and Food Insecurity in Africa—A Syndemics-Based Scoping Review

Ojo

Ruan

Hameed

et al. 2022

IJERPH

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The double burden of HIV/AIDS and tuberculosis (TB), coupled with endemic and problematic food insecurity in Africa, can interact to negatively impact health outcomes, creating a syndemic. For people living with HIV/AIDS (PWH), food insecurity is a significant risk factor for acquiring TB due to the strong nutritional influences and co-occurring contextual barriers. We aim to synthesize evidence on the syndemic relationship between HIV/AIDS and TB co-infection and food insecurity in Africa. We conducted a scoping review of studies in Africa that included co-infected adults and children, with evidence of food insecurity, characterized by insufficient to lack of access to macronutrients. We sourced information from major public health databases. Qualitative, narrative analysis was used to synthesize the data. Of 1072 articles screened, 18 articles discussed the syndemic effect of HIV/AIDS and TB co-infection and food insecurity. Reporting of food insecurity was inconsistent, however, five studies estimated it using a validated scale. Food insecure co-infected adults had an average BMI of 16.5–18.5 kg/m2. Negative outcomes include death (n = 6 studies), depression (n = 1 study), treatment non-adherence, weight loss, wasting, opportunistic infections, TB-related lung diseases, lethargy. Food insecurity was a precursor to co-infection, especially with the onset/increased incidence of TB in PWH. Economic, social, and facility-level factors influenced the negative impact of food insecurity on the health of co-infected individuals. Nutritional support, economic relief, and psychosocial support minimized the harmful effects of food insecurity in HIV–TB populations. Interventions that tackle one or more components of a syndemic interaction can have beneficial effects on health outcomes and experiences of PWH with TB in Africa.

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Adherence to HIV and TB Care and Treatment, the Role of Food Security and Nutrition

Cited by 11 publications

References 15 publications

“I’m suffering for food”: Food insecurity and access to social protection for TB patients and their households in Cape Town, South Africa

“I’m suffering for food”: Food insecurity and access to social protection for TB patients and their households in Cape Town, South Africa

Food Security Status is Related to Mental Health Quality of Life Among Persons Living with HIV

HIV, Tuberculosis, and Food Insecurity in Africa—A Syndemics-Based Scoping Review

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