Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 7/2020

01-07-2020 | Human Immunodeficiency Virus | Original Paper

The Mediating Role of Depressive Symptoms in the Association Between Food Insecurity and HIV Related Health Outcomes Among HIV–HCV Co-Infected People

Authors: Wusiman Aibibula, Joseph Cox, Anne-Marie Hamelin, Marina B. Klein, Paul Brassard

Published in: AIDS and Behavior | Issue 7/2020

Login to get access

Abstract

Food insecurity may lead to depressive symptoms, which are known to be associated with poor HIV related health outcomes. However, it is unclear to what extent food insecurity ‘directly’ affects these outcomes. We used data from the Food Security & HIV–HCV Sub-Study of the Canadian Co-Infection Cohort to assess the controlled direct effect. People experiencing severe food insecurity had 1.47 (95% CI 1.04–2.09) times the risk of having detectable HIV viral load and 0.94 (95% CI 0.87–1.02) fold change in CD4 count. After holding depressive symptoms constant, the association between severe food insecurity and HIV viral load was attenuated to a statistically non-significant level (RR 1.36, 95% CI: 0.95–1.96), whereas the association between severe food insecurity and CD4 count was unchanged. Depressive symptoms partially mediate the effect of severe food insecurity on HIV viral suppression; interventions focused on depressive symptoms alone may not be sufficient, however, to eliminate this effect.
Appendix
Available only for authorised users
Literature
1.
Anderson SA. Core indicators of nutritional state for difficult-to-sample populations. J Nutr. 1990;120(Suppl 11):1559–600.
2.
Anema A, Weiser SD, Fernandes KA, et al. High prevalence of food insecurity among HIV-infected individuals receiving HAART in a resource-rich setting. AIDS care. 2011;23(2):221–30.PubMed
3.
Cox J, Hamelin AM, McLinden T, et al. Food insecurity in HIV–Hepatitis C virus co-infected individuals in Canada: the importance of co-morbidities. AIDS Behav. 2017;21(3):792–802.PubMed
4.
Palar K, Kushel M, Frongillo EA, et al. Food insecurity is longitudinally associated with depressive symptoms among homeless and marginally-housed individuals living with HIV. AIDS Behav. 2015;19(8):1527–34.PubMedPubMedCentral
5.
Weiser SD, Palar K, Frongillo EA, et al. Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda. AIDS (London, England). 2014;28(1):115–20.PubMedCentral
6.
Kalichman SC, Washington C, Grebler T, et al. Treatment outcomes among people living with HIV who are food insecure and prescribed antiretrovirals taken with food. J Prim Care Community Health. 2015;6(1):35–40.PubMed
7.
Weiser SD, Yuan C, Guzman D, et al. Food insecurity and HIV clinical outcomes in a longitudinal study of urban homeless and marginally housed HIV-infected individuals. AIDS (London, England). 2013;27(18):2953–8.PubMedCentral
8.
Aibibula W, Cox J, Hamelin AM, Mamiya H, Klein MB, Brassard P. Food insecurity and low CD4 count among HIV-infected people: a systematic review and meta-analysis. AIDS Care. 2016;28(12):1577–85.PubMed
9.
Aibibula W, Cox J, Hamelin AM, McLinden T, Klein MB, Brassard P. Association between food insecurity and hiv viral suppression: a systematic review and meta-analysis. AIDS Behav. 2017;21(3):754–65.PubMed
10.
Aibibula W, Cox J, Hamelin AM, et al. Food insecurity may lead to incomplete HIV viral suppression and less immune reconstitution among HIV/hepatitis C virus-coinfected people. HIV Med. 2018;19(2):123–31.PubMed
11.
Chakraborty H, Sen PK, Helms RW, et al. Viral burden in genital secretions determines male-to-female sexual transmission of HIV-1: a probabilistic empiric model. AIDS (London, England). 2001;15(5):621–7.
12.
Garcia PM, Kalish LA, Pitt J, et al. Maternal levels of plasma human immunodeficiency virus type 1 RNA and the risk of perinatal transmission. N Engl J Med. 1999;341(6):394–402.PubMed
13.
Nagata JM, Palar K, Gooding HC, et al. Food Insecurity Is Associated With Poorer Mental Health and Sleep Outcomes in Young Adults. J Adolesc Health. 2019;65(6):805–11.PubMed
14.
Arenas DJ, Thomas A, Wang J, DeLisser HM. A systematic review and meta-analysis of depression, anxiety, and sleep disorders in US adults with food insecurity. J Gen Intern Med. 2019;34(12):2874–82.PubMed
15.
Whittle HJ, Sheira LA, Wolfe WR, et al. Food insecurity is associated with anxiety, stress, and symptoms of posttraumatic stress disorder in a cohort of women with or at risk of HIV in the United States. J Nutr. 2019;149(8):1393–403.PubMed
16.
Rani D, Singh JK, Acharya D, Paudel R, Lee K, Singh SP. Household food insecurity and mental health among teenage girls living in urban slums in Varanasi, India: a cross-sectional study. Int J Environ Res Public Health. 2018;15(8):1585.PubMedCentral
17.
Hadley C, Tegegn A, Tessema F, Cowan JA, Asefa M, Galea S. Food insecurity, stressful life events and symptoms of anxiety and depression in east Africa: evidence from the Gilgel Gibe growth and development study. J Epidemiol Community Health. 2008;62(11):980–6.PubMed
18.
Palar K, Frongillo EA, Escobar J, et al. Food insecurity, internalized stigma, and depressive symptoms among women living with HIV in the United States. AIDS Behav. 2018;22(12):3869–78.PubMedPubMedCentral
19.
Aibibula W, Cox J, Hamelin AM, et al. Impact of food insecurity on depressive symptoms among HIV–HCV co-infected people. AIDS Behav. 2017;21(12):3464–72.PubMed
20.
Vogenthaler NS, Hadley C, Rodriguez AE, Valverde EE, del Rio C, Metsch LR. Depressive symptoms and food insufficiency among HIV-infected crack users in Atlanta and Miami. AIDS Behav. 2011;15(7):1520–6.PubMedPubMedCentral
21.
Tuthill EL, Sheira LA, Palar K, et al. Persistent food insecurity is associated with adverse mental health among women living with or at risk of HIV in the United States. J Nutr. 2019;149(2):240–8.PubMedPubMedCentral
22.
Mayston R, Kinyanda E, Chishinga N, Prince M, Patel V. Mental disorder and the outcome of HIV/AIDS in low-income and middle-income countries: a systematic review. AIDS (London, England). 2012;26(Suppl 2):S117–135.
23.
Mehrotra ML, Glidden DV, McMahan V, et al. The effect of depressive symptoms on adherence to daily oral PrEP in men who have sex with men and transgender women: a marginal structural model analysis of the iPrEx OLE study. AIDS Behav. 2016;20(7):1527–34.PubMedPubMedCentral
24.
Smith Fawzi MC, Ng L, Kanyanganzi F, et al. Mental health and antiretroviral adherence among youth living with HIV in Rwanda. Pediatrics. 2016;138(4):e20153235.PubMedPubMedCentral
25.
Wagner GJ, Goggin K, Remien RH, et al. A closer look at depression and its relationship to HIV antiretroviral adherence. Annals Behav Med: Publ Soc Behav Med. 2011;42(3):352–60.
26.
Salas J, Scherrer JF, Tuerk P, et al. Large posttraumatic stress disorder improvement and antidepressant medication adherence. J Affect Disord. 2019;260:119–23.PubMed
27.
Whittle HJ, Sheira LA, Frongillo EA, et al. Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States. Addiction. 2019;114(1):127–36.PubMed
28.
Sanchez-Rivero I, Madoz-Gurpide A, Parro-Torres C, Hernandez-Huerta D, Ochoa ME. Influence of substance use and cognitive impairment on adherence to antiretroviral therapy in HIV+ patients. Adicciones. 2018;1(1):1025.
29.
Amin P, Douaihy A. Substance use disorders in people living with human immunodeficiency virus/AIDS. Nurs Clin North Am. 2018;53(1):57–655.PubMed
30.
Kim MH, Mazenga AC, Yu X, et al. High self-reported non-adherence to antiretroviral therapy amongst adolescents living with HIV in Malawi: barriers and associated factors. J Int AIDS Soc. 2017;20(1):21437.PubMedPubMedCentral
31.
Jiang W, Luo Z, Martin L, et al. Drug use is associated with anti-CD4 IgG-mediated CD4+ T cell death and poor CD4+ T cell recovery in viral-suppressive HIV-infected individuals under antiretroviral therapy. Curr HIV Res. 2018;16(2):143–50.PubMedPubMedCentral
32.
Whittle HJ, Palar K, Seligman HK, Napoles T, Frongillo EA, Weiser SD. How food insecurity contributes to poor HIV health outcomes: qualitative evidence from the San Francisco Bay Area. Soc Sci Med. 2016;170:228–36.PubMed
33.
Kirkpatrick SI, Tarasuk V. Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. J Nutr. 2008;138(3):604–12.PubMed
34.
Chandra RK. Numerical and functional deficiency in T helper cells in protein energy malnutrition. Clin Exp Immunol. 1983;51(1):126–32.PubMedPubMedCentral
35.
Aibibula W, Cox J, Hamelin AM, et al. Association between depressive symptoms, CD4 count and HIV viral suppression among HIV–HCV co-infected people. AIDS Care. 2018;30(5):1–7.
36.
37.
Klein MB, Saeed S, Yang H, et al. Cohort profile: the Canadian HIV–hepatitis C co-infection cohort study. Int J Epidemiol. 2010;39(5):1162–9.PubMed
38.
39.
Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prevent Med. 1994;10(2):77–84.
40.
Boey KW. Cross-validation of a short form of the CES-D in Chinese elderly. Int J Geriatr Psychiatr. 1999;14(8):608–17.
41.
Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med. 1999;159(15):1701–4.PubMed
42.
Zhang W, O'Brien N, Forrest JI, et al. Validating a shortened depression scale (10 item CES-D) among HIV-positive people in British Columbia, Canada. PLoS ONE. 2012;7(7):e40793.PubMedPubMedCentral
43.
Rubin DB, Schenker N. Multiple imputation in health-care databases: an overview and some applications. Stat Med. 1991;10(4):585–98.PubMed
44.
Robins JM, Hernan MA, Brumback B. Marginal structural models and causal inference in epidemiology. Epidemiology (Cambridge, Mass). 2000;11(5):550–60.
45.
Greenland S. Quantifying biases in causal models: classical confounding vs collider-stratification bias. Epidemiology (Cambridge, Mass). 2003;14(3):300–6.
46.
VanderWeele TJ. Marginal structural models for the estimation of direct and indirect effects. Epidemiology (Cambridge, Mass). 2009;20(1):18–26.
47.
Hernan MA, Robins JM. Estimating causal effects from epidemiological data. J Epidemiol Community Health. 2006;60(7):578–86.PubMedPubMedCentral
48.
Greenland S. Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case-control studies. Am J Epidemiol. 2004;160(4):301–5.PubMed
49.
Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.PubMed
50.
Wei X, Ghosh SK, Taylor ME, et al. Viral dynamics in human immunodeficiency virus type 1 infection. Nature. 1995;373(6510):117–22.PubMed
51.
Chop E, Duggaraju A, Malley A, et al. Food insecurity, sexual risk behavior, and adherence to antiretroviral therapy among women living with HIV: a systematic review. Health Care Women Int. 2017;38(9):927–44.PubMedPubMedCentral
52.
Cornelius T, Jones M, Merly C, Welles B, Kalichman MO, Kalichman SC. Impact of food, housing, and transportation insecurity on ART adherence: a hierarchical resources approach. AIDS Care. 2017;29(4):449–57.PubMed
53.
Koehn K, McLinden T, Collins AB, et al. Assessing the impact of food insecurity on HIV medication adherence in the context of an integrated care programme for people living with HIV in Vancouver, Canada. Public Health Nutr. 2019:1–8.
54.
Ho DD, Neumann AU, Perelson AS, Chen W, Leonard JM, Markowitz M. Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection. Nature. 1995;373(6510):123–6.PubMed
55.
Bonner K, Mezochow A, Roberts T, Ford N, Cohn J. Viral load monitoring as a tool to reinforce adherence: a systematic review. J Acquir Immun Defic Syndr.2013;64(1):74–8.
56.
Schneeweiss S. Sensitivity analysis and external adjustment for unmeasured confounders in epidemiologic database studies of therapeutics. Pharmacoepidemiol Drug Saf. 2006;15(5):291–303.PubMed
57.
Westreich D, Cole SR. Invited commentary: positivity in practice. Am J Epidemiol. 2010;171(6):674–7. discussion 678-681.PubMedPubMedCentral
Metadata
Title
The Mediating Role of Depressive Symptoms in the Association Between Food Insecurity and HIV Related Health Outcomes Among HIV–HCV Co-Infected People
Authors
Wusiman Aibibula
Joseph Cox
Anne-Marie Hamelin
Marina B. Klein
Paul Brassard
Publication date
01-07-2020
Publisher
Springer US
Published in
AIDS and Behavior / Issue 7/2020
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-020-02784-7

Other articles of this Issue 7/2020

AIDS and Behavior 7/2020 Go to the issue

Correction

Correction to: Ugandan Study Participants Experience Electronic Monitoring of Antiretroviral Therapy Adherence as Welcomed Pressure to Adhere

Notes From The Field

How Do We Balance Tensions Between COVID-19 Public Health Responses and Stigma Mitigation? Learning from HIV Research

Original Paper

#HIV: Alignment of HIV-Related Visual Content on Instagram with Public Health Priorities in the US

Original Paper

The Influence of Relationship Dynamics and Sexual Agreements on Perceived Partner Support and Benefit of PrEP Use Among Same-Sex Male Couples in the U.S.

Notes from the field

Achieve Research Continuity During Social Distancing by Rapidly Implementing Individual and Group Videoconferencing with Participants: Key Considerations, Best Practices, and Protocols

Notes From The Field

Collective Call to Action for HIV/AIDS Community-Based Collaborative Science in the Era of COVID-19
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits