Food Insecurity and Unmet Needs Among Youth and Young Adults Living With HIV in the San Francisco Bay Area

Abstract

Little is known about food insecurity and unmet subsistence needs and their association with antiretroviral therapy adherence among youth and young adults living with HIV (YLWH). Methods: We conducted a cross-sectional survey to examine this association in 101 YLWH (aged 18e29 years). Poisson regression models with robust standard errors were used to estimate adjusted risk ratios (RRs) and 95% confidence intervals (CIs).Results: Approximately 51.7% of participants experienced at least one unmet subsistence need (difficulty finding enough to eat [36.6%], clothing [22.8%], place to sleep [21.8%], place to wash [17.8%], and bathroom [15.8%]), and 64.2% reported being food insecure. For every additional unmet need, the risk of very good/excellent adherence was reduced by 15% (RR ¼ .85; 95% CI ¼ .72e.99; p value ¼ .04). The risk of very good/excellent adherence was lowered by 39% (RR ¼ .61; 95% CI ¼ .43e.87; p value ¼ .005) among food insecure youth, compared with those who were food secure. Conclusions: These data highlight the need for more research and structural interventions targeting food assistance strategies among YLWH.

Is the experience of hunger associated with risk of engaging in condomless anal sex among minority young men who have sex with men?

“…For instance, a recent study of San Francisco, CA youth living with HIV found that recent hunger was experienced by 36.3%. 31 Clearly, however (regardless of the comparison) hunger was disproportionately common in this sample of minority MSM. Second, the number of male partners in the past six months was equally high regardless of hunger.…”

Video-Counseling Intervention to Address HIV Care Engagement, Mental Health, and Substance Use Challenges: A Pilot Randomized Clinical Trial for Youth and Young Adults Living with HIV

“…GAD scores questions such that a high score (10-21) indicates evidence of anxiety and a score <10 indicates minimal-mild anxiety. PHQ-9 scores depression-related questions that are categorized as ''None'' (0), ''Minimal'' (1-4), ''Mild'' (5-9), ''Moderate'' (10)(11)(12)(13)(14), ''Moderately severe'' (15)(16)(17)(18)(19), and ''Severe'' (20-100). PCL-5 groups the questions as either unlikely to have PTSD (0-32) or high likelihood of having PTSD .…”

“…9 Moreover, YLWH may experience other barriers such as unstable housing, food insecurity, low socioeconomic status, and stigma that are often entangled with mental health and substance use challenges and can additionally negatively impact HIV clinical outcomes. 10 Despite the adverse impact that mental health and substance use challenges have on HIV clinical outcomes, there remains a shortage of behavioral health services and evidence-based interventions tailored to YLWH. 5 Although several interventions have been developed to address mental health, substance use, and other psychosocial factors to improve ART adherence for adults, 11,12 few interventions take into account unique aspects of youth developmental phases, culture, and priorities such as technology use.…”

“… 9 Moreover, YLWH may experience other barriers such as unstable housing, food insecurity, low socioeconomic status, and stigma that are often entangled with mental health and substance use challenges and can additionally negatively impact HIV clinical outcomes. 10 …”

Development of the Mobile Technology Vulnerability Scale among Youth and Young Adults Living with HIV

“…Participants and Study Design: We developed the Mobile Technology Vulnerability Scale (MTVS) among 18–29-year-olds living with HIV recruited for a longitudinal pilot trial, evaluating the feasibility and acceptability of a mobile health application called WYZ [ 14 ]. MTVS is analogous to the food insecurity scale [ 15 ] and examines how secure or stable an individual feels regarding their personal access to mobile technology.…”