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 8/2015

01-08-2015 | Substantive Review

Does Food Insecurity Undermine Adherence to Antiretroviral Therapy? A Systematic Review

Authors: Amanda W. Singer, Sheri D. Weiser, Sandra I. McCoy

Published in: AIDS and Behavior | Issue 8/2015

Login to get access

Abstract

A growing body of research has identified food insecurity as a barrier to antiretroviral therapy (ART) adherence. We systematically reviewed and summarized the quantitative literature on food insecurity or food assistance and ART adherence. We identified nineteen analyses from eighteen distinct studies examining food insecurity and ART adherence. Of the thirteen studies that presented an adjusted effect estimate for the relationship between food insecurity and ART adherence, nine found a statistically significant association between food insecurity and sub-optimal ART adherence. Four studies examined the association between food assistance and ART adherence, and three found that ART adherence was significantly better among food assistance recipients than non-recipients. Across diverse populations, food insecurity is an important barrier to ART adherence, and food assistance appears to be a promising intervention strategy to improve ART adherence among persons living with HIV. Additional research is needed to determine the effectiveness and cost-effectiveness of food assistance in improving ART adherence and other clinical outcomes among people living with HIV in the era of widespread and long-term treatment.
Appendix
Available only for authorised users
Literature
1.
Bangsberg DR, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15(9):1181–3.PubMedCrossRef
2.
Maggiolo F, et al. Similar adherence rates favor different virologic outcomes for patients treated with nonnucleoside analogues or protease inhibitors. Clin Infect Dis. 2005;40(1):158–63.PubMedCrossRef
3.
Sungkanuparph S, et al. Rapid CD4 decline after interruption of non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy in a resource-limited setting. AIDS Res Ther. 2007;4:26.PubMedCentralPubMedCrossRef
4.
Kiwuwa-Muyingo S, et al. The impact of first year adherence to antiretroviral therapy on long-term clinical and immunological outcomes in the DART trial in Uganda and Zimbabwe. Trop Med Int Health. 2012;17(5):584–94.PubMedCrossRef
5.
6.
Mills EJ, et al. Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA. 2006;296(6):679–90.PubMedCrossRef
7.
WHO. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva: WHO; 2013.
8.
Nagata JM, et al. Social determinants, lived experiences, and consequences of household food insecurity among persons living with HIV/AIDS on the shore of Lake Victoria, Kenya. AIDS Care. 2012;24(6):728–36.PubMedCentralPubMedCrossRef
9.
Goudge J, Ngoma B. Exploring antiretroviral treatment adherence in an urban setting in South Africa. J Public Health Policy. 2011;32(Suppl 1):S52–64.PubMedCrossRef
10.
11.
AO F. Rome declaration on world food security. Rome: Food and Agriculture Organization; 1996.
12.
Frega R, et al. Food insecurity in the context of HIV/AIDS: a framework for a new era of programming. Food Nutr Bull. 2010;31(4):S292–312.
13.
Weiser SD, et al. Food insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. J Gen Intern Med. 2009;24(1):14–20.PubMedCentralPubMedCrossRef
14.
Wang EA, et al. Food insecurity is associated with poor virologic response among HIV-infected patients receiving antiretroviral medications. J Gen Intern Med. 2011;26(9):1012–8.PubMedCentralPubMedCrossRef
15.
Weiser SD, et al. Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda. AIDS. 2014;28(1):115–20.
16.
Weiser SD, et al. Food insecurity and HIV clinical outcomes in a longitudinal study of homeless and marginally housed HIV-infected individuals in San Francisco. AIDS. 2013;27(18):2953–8.
17.
McMahon JH, et al. Repeated assessments of food security predict CD4 change in the setting of antiretroviral therapy. J Acquir Immune Defic Syndr. 2011;58(1):60–3.PubMedCentralPubMedCrossRef
18.
Normen L, et al. Food insecurity and hunger are prevalent among HIV-positive individuals in British Columbia, Canada. J Nutr. 2005;135(4):820–5.PubMed
19.
Weiser SD, et al. Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting. AIDS. 2012;26(1):67–75.PubMedCentralPubMedCrossRef
20.
Weiser SD, et al. The association between food insecurity and mortality among HIV-infected individuals on HAART. J Acquir Immune Defic Syndr. 2009;52(3):342–9.PubMedCentralPubMedCrossRef
21.
Weiser SD, et al. Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. Am J Clin Nutr. 2011;94(6):1729S–39S.PubMedCentralPubMedCrossRef
22.
Cantrell RA, et al. A pilot study of food supplementation to improve adherence to antiretroviral therapy among food-insecure adults in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2008;49(2):190–5.PubMedCrossRef
23.
Ivers LC, et al. Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: a prospective observational cohort study. AIDS Res Ther. 2010;7:33.PubMedCentralPubMedCrossRef
24.
25.
Anema A, et al. Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries. Public Health Nutr. 2012;15(5):938–47.PubMedCrossRef
26.
Lamb MR, et al. Association of adherence support and outreach services with total attrition, loss to follow-up, and death among ART patients in sub-Saharan Africa. PLoS ONE. 2012;7(6):e38443.PubMedCentralPubMedCrossRef
27.
28.
Ndekha M, et al. Nutritional status of Malawian adults on antiretroviral therapy 1 year after supplementary feeding in the first 3 months of therapy. Trop Med Int Health. 2009;14(9):1059–63.PubMedCrossRef
29.
Ndekha MJ, et al. Supplementary feeding with either ready-to-use fortified spread or corn-soy blend in wasted adults starting antiretroviral therapy in Malawi: randomised, investigator blinded, controlled trial. BMJ. 2009;338:b1867.PubMedCentralPubMedCrossRef
30.
Kabore I, et al. The effect of community-based support services on clinical efficacy and health-related quality of life in HIV/AIDS patients in resource-limited settings in sub-Saharan Africa. AIDS Patient Care STDS. 2010;24(9):581–94.PubMedCrossRef
31.
Franke MF, et al. Improved Retention Associated With Community-Based Accompaniment for Antiretroviral Therapy Delivery in Rural Rwanda. Clin Infect Dis. 2013;56(9):1319–26.PubMedCrossRef
32.
Nyamathi A, et al. Impact of a rural village women (Asha) intervention on adherence to antiretroviral therapy in southern India. Nurs Res. 2012;61(5):353–62.PubMedCentralPubMedCrossRef
33.
Talisuna-Alamo S, et al. Socioeconomic support reduces nonretention in a comprehensive, community-based antiretroviral therapy program in Uganda. J Acquir Immune Defic Syndr. 2012;59(4):e52–9.PubMedCrossRef
34.
Biadgilign S, et al. Adherence to highly active antiretroviral therapy and its correlates among HIV infected pediatric patients in Ethiopia. BMC Pediatr. 2008;8:53.PubMedCentralPubMedCrossRef
35.
Stroup DF, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.PubMedCrossRef
36.
StataCorp. Stata statistical software: Release 12, 2011, StataCorp LP: College Station, TX.
37.
Anema A, 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.PubMedCrossRef
38.
Peretti-Watel P, et al. Vulnerability, unsafe sex and non-adherence to HAART: evidence from a large sample of French HIV/AIDS outpatients. Soc Sci Med. 2006;62(10):2420–33.PubMedCrossRef
39.
Young S, et al. A review of the role of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS. AIDS Behav. 2013. doi:10.​1007/​s10461-013-0547-4.
40.
Kalichman SC, et al. Health and treatment implications of food insufficiency among people living with HIV/AIDS, Atlanta, Georgia. J Urban Health. 2010;87(4):631–41.PubMedCentralPubMedCrossRef
41.
Kalichman SC, et al. Food insufficiency and medication adherence among people living with HIV/AIDS in urban and peri-urban settings. Prev Sci. 2011;12(3):324–32.PubMedCrossRef
42.
Boyer S, et al. Non-adherence to antiretroviral treatment and unplanned treatment interruption among people living with HIV/AIDS in Cameroon: individual and healthcare supply-related factors. Soc Sci Med. 2011;72(8):1383–92.PubMedCrossRef
43.
Marcellin F, et al. Determinants of unplanned antiretroviral treatment interruptions among people living with HIV in Yaounde, Cameroon (EVAL survey, ANRS 12-116). Trop Med Int Health. 2008;13(12):1470–8.PubMedCrossRef
44.
Posse M, et al. The effect of food assistance on adherence to antiretroviral therapy among HIV/AIDS patients in Sofala Province, in Mozambique: a retrospective study. J AIDS Clin Res. 2013;4(3):1000198. doi:10.​4172/​2155-6113.​1000198.
45.
Gebo KA, Keruly J, Moore RD. Association of social stress, illicit drug use, and health beliefs with nonadherence to antiretroviral therapy. J Gen Intern Med. 2003;18(2):104–11.PubMedCentralPubMedCrossRef
46.
Kalichman SC, Grebler T. Stress and poverty predictors of treatment adherence among people with low-literacy living with HIV/AIDS. Psychosom Med. 2010;72(8):810–6.PubMedCentralPubMedCrossRef
47.
Anema A, et al. Relationship between food insecurity and mortality among HIV-positive injection drug users receiving antiretroviral therapy in British Columbia, Canada. PLoS ONE. 2013;8(5):e61277.
48.
Kelly A, et al. Moresby food isn’t good: food security, nutritional information and adherence to antiretroviral therapy in Papua New Guinea. P N G Med J. 2011;54(1–2):23–34.PubMed
49.
Van Dyk AC. Treatment adherence following national antiretroviral rollout in South Africa. Ajar-Afr J Aids Res. 2010;9(3):235–47.CrossRef
50.
Birbeck GL, et al. Neuropsychiatric and socioeconomic status impact antiretroviral adherence and mortality in rural Zambia. Am J Trop Med Hyg. 2011;85(4):782–9.PubMedCentralPubMedCrossRef
51.
Franke MF, et al. Food insufficiency is a risk factor for suboptimal antiretroviral therapy adherence among HIV-infected adults in urban Peru. AIDS Behav. 2011;15(7):1483–9.PubMedCentralPubMedCrossRef
52.
Sasaki Y, et al. Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients. Ann Clin Microbiol Antimicrob. 2012;11:34.PubMedCentralPubMedCrossRef
53.
Parashar S, et al. Sticking to it: the effect of maximally assisted therapy on antiretroviral treatment adherence among individuals living with HIV who are unstably housed. AIDS Behav. 2011;15(8):1612–22.PubMedCrossRef
54.
Berhe N, Tegabu D, Alemayehu M. Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: a case control study in Northern Ethiopia. BMC Infect Dis. 2013;13:233.PubMedCentralPubMedCrossRef
55.
Sterne JAC, Harbord RM. Funnel plots in meta-analysis. Stata J. 2004;4(2):127–41.
56.
Tirivayi N, Koethe JR, Groot W. Clinic-based food assistance is associated with increased medication adherence among HIV-infected adults on long-term antiretroviral therapy in Zambia. J AIDS Clin Res. 2012;3(7):171.PubMedCentralPubMedCrossRef
57.
Serrano C, et al. Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country. Asia Pac J Clin Nutr. 2010;19(1):68–75.PubMed
58.
Chesney MA. Factors affecting adherence to antiretroviral therapy. Clin Infect Dis. 2000;30(Suppl 2):S171–6.PubMedCrossRef
59.
Spire B, et al. Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to a dynamic approach. Soc Sci Med. 2002;54(10):1481–96.PubMedCrossRef
60.
Gutierrez EB, et al. Measuring adherence to antiretroviral treatment: the role of pharmacy records of drug withdrawals. AIDS Behav. 2012;16(6):1482–90.PubMedCrossRef
61.
Palar K, et al. Role of antiretroviral therapy in improving food security among patients initiating HIV treatment and care. AIDS. 2012;26(18):2375–81.PubMedCrossRef
62.
Weiser SD, et al. Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda. J Acquir Immune Defic Syndr. 2012;61(2):179–86.PubMedCentralPubMedCrossRef
63.
McCoy SI, et al. Food insecurity, socioeconomic status, and HIV-related risk behavior among women in farming households in Tanzania. AIDS Behav. 2014;18(7):1224–36.
64.
Riley ED, et al. Basic subsistence needs and overall health among human immunodeficiency virus-infected homeless and unstably housed women. Am J Epidemiol. 2011;174(5):515–22.PubMedCentralPubMedCrossRef
65.
Mugavero MJ, Norton WE, Saag MS. Health care system and policy factors influencing engagement in HIV medical care: piecing together the fragments of a fractured health care delivery system. Clin Infect Dis. 2011;52(Suppl 2):S238–46.PubMedCentralPubMedCrossRef
66.
McNairy ML, El-Sadr WM. The HIV care continuum: no partial credit given. AIDS. 2012;26(14):1735–8.
67.
de Pee S, et al. Antiretroviral therapy requires life-long adherence. Lancet Infect Dis. 2012; 12(9):661–662; author reply 662.
68.
Galarraga O, et al. Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations. AIDS Behav. 2013;17(7):2283–92.PubMedCentralPubMedCrossRef
69.
McCoy SI. Comparing food and cash assistance for HIV-positive men and women on antiretroviral therapy in Tanzania. 2013 [cited 2014 06/07/2014].
70.
Barnighausen T, et al. Interventions to increase antiretroviral adherence in sub-Saharan Africa: a systematic review of evaluation studies. Lancet Infect Dis. 2011;11(12):942–51.PubMedCentralPubMedCrossRef
71.
Grobler L, et al. Nutritional interventions for reducing morbidity and mortality in people with HIV. Cochrane Database Syst Rev. 2013;2:CD004536.PubMed
72.
Tirivayi N, Groot W. Health and welfare effects of integrating AIDS treatment with food assistance in resource constrained settings: a systematic review of theory and evidence. Soc Sci Med. 2011;73(5):685–92.PubMedCrossRef
73.
Koethe JR, et al. Macronutrient supplementation for malnourished HIV-infected adults: a review of the evidence in resource-adequate and resource-constrained settings. Clin Infect Dis. 2009;49(5):787–98.PubMedCentralPubMedCrossRef
Metadata
Title
Does Food Insecurity Undermine Adherence to Antiretroviral Therapy? A Systematic Review
Authors
Amanda W. Singer
Sheri D. Weiser
Sandra I. McCoy
Publication date
01-08-2015
Publisher
Springer US
Published in
AIDS and Behavior / Issue 8/2015
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-014-0873-1

Other articles of this Issue 8/2015

AIDS and Behavior 8/2015 Go to the issue

Original Paper

Health Outcomes of HIV-Infected People with Mental Illness

Original Paper

Abuse Impedes Prevention: The Intersection of Intimate Partner Violence and HIV/STI Risk Among Young African American Women

Original Paper

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

Original Paper

Family Functioning and Child Behavioral Problems in Households Affected by HIV and AIDS in Kenya

Original Paper

“Please Don’t Make Me Ask for Help”: Implicit Social Support and Mental Health in Chinese Individuals Living with HIV

Original Paper

Factors Associated with Missed Psychiatry Visits in an Urban HIV Clinic
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