title: Social determinants, lived experiences, and consequences of household food insecurity among persons living with HIV/AIDS on the shore of Lake Victoria, Kenya.
abstract: Food insecurity is a considerable challenge in sub-Saharan Africa, disproportionately affecting persons living with HIV/AIDS. This study investigates the lived experience, determinants, and consequences of food insecurity and hunger among individuals living with HIV/AIDS on the shore of Lake Victoria in Suba District, Kenya. Parallel mixed methods included semi-structured interviews and administration of the Household Food Insecurity Access Scale among a systematic sample of 67 persons living with HIV/AIDS (49 of whom were receiving antiretroviral therapy [ART]). All respondents were either severely (79.1%) or moderately (20.9%) food insecure; no respondents were mildly food insecure or food secure. Qualitative data and simple and multiple linear regression models indicated that significant determinants of food insecurity include increased age, a greater number of children, and not being married. A number of themes related to food insecurity and ART emerged, including: (1) an increase in hunger or appetite since initiating ART; (2) exacerbation of ART-related side effects; and (3) non-adherence to ART due to hunger, food insecurity, or agricultural work responsibilities. HIV interventions should address food insecurity and hunger, particularly among at-risk populations, to promote ART adherence and better health outcomes.
authors.affiliation: Institute of Social and Cultural Anthropology, University of Oxford, UK. jason.nagata@ucsf.edu
authors.forename: Jason M
authors.initials: JM
authors.lastname: Nagata
authors.forename: Richard O
authors.initials: RO
authors.lastname: Magerenge
authors.forename: Sera L
authors.initials: SL
authors.lastname: Young
authors.forename: Joel O
authors.initials: JO
authors.lastname: Oguta
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D006801:Humans; D006815:Hunger; D007630:Kenya / Q000453:epidemiology; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D055118:Medication Adherence / Q000523:psychology*; D011203:Poverty / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents