Food Insecurity and Its Relation to Psychological Well-Being Among South Indian People Living with HIV

Abstract

Food insecurity (FI) and its link with depression and quality of life (QOL) among people living with HIV (PLHIV) in India are not well-documented. We analyzed cohort data from 243 male and 129 female PLHIV from Bengaluru, and found 19% of men and 26% of women reported moderate or severe FI over a six-month period. Women reported higher mean depression than men, and lower mean QOL. In multivariate analyses adjusting for HIV stigma and demographic covariates, both male and female PLHIV with moderate to severe FI showed lower mean QOL than those reporting mild to no FI. Male but not female food insecure participants also had higher depression scores in adjusted regression analyses. As ART has improved the physical health of PLHIV, more effort is being invested in improving their psychological well-being. Our results suggest such interventions could benefit from including nutritional support to reduce FI among PLHIV.

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

“…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).…”

“…resource-limited or resource–rich country), exhibit high prevalence of food insecurity (25). Prevalence for food insecurity among PLHIV range from 24% – 81% (26–35). Food insecurity may promote HIV transmission because it compromises nutritional status, and consequently, functioning of the immune system (36).…”

“…Engaging in risky sexual behaviors, also encourages HIV disease transmission, and is more likely among infected individuals who are food insecure (37–39). Among PLHIV, food insecurity is also negatively associated with access to care (40, 41), adherence to treatment (32,42), CD4 levels (28, 31), viral load suppression (30, 32), opportunistic infections and hospitalization (41), common mental disorders including depression (33–35,43), and mortality (44, 45). …”

“…An emerging body of research (mainly from resource-limited settings) has begun exploring the relationship between food insecurity and quality of life among PLHIV (33,35,46,47). All the studies found a negative association between food insecurity and quality of life, however, only one study (47) assessed this relationship with respect to the multidimensional nature of HRQoL.…”

Insegurança alimentar moderada e grave em famílias integradas por pessoas vivendo com HIV/Aids: validação da escala e fatores associados

“…PLHA experiencing FI have a 1.29 times higher likelihood of showing incomplete viral load suppression and a 1.48 times higher likelihood of failing to comply with the treatment 31 . A follow-up study with PLHA conducted in India found that moderate or severe FI is a risk factor for depression among male patients, reinforcing the notion that food assistance may decrease stress and provide key benefits for the treatment of PLHA 32 . FI and compromised nutritional status may accelerate the progression of diseases related to AIDS, impair the compliance with and response to ARVT and exacerbate the socioeconomic impacts of the virus.…”