title: Treatment outcomes among people living with HIV who are food insecure and prescribed antiretrovirals taken with food.
abstract: BACKGROUND
  Food insecurity is a known barrier to medication adherence among people living with HIV. Antiretroviral therapies (ART) that require food likely pose added challenges to patients who do not have reliable access to food. This study examines the health implications of prescribing ART that requires food to patients who are food insecure.
  
  
  METHODS
  A community sample of 538 men and 221 women currently taking ART to treat their HIV infection completed computerized interviews, biweekly unannounced pill count adherence assessments, and obtained their HIV RNA (viral load) and CD4 cell count from medical records.
  
  
  RESULTS
  Sixty-three percent of participants experienced at least 1 indicator of food insecurity during the previous month, of which 274 (57%) were prescribed an ART regimen that requires food. Among participants who were food insecure, individuals taking ART requiring food indicated significantly greater HIV symptoms, had lower CD4 cell counts, and poorer HIV suppression. For participants who were food secure, those taking ART that requires food were significantly less adherent than those whose ART regimen does not require food.
  
  
  CONCLUSIONS
  People living with HIV who experience food insecurity are significantly more likely to be prescribed ART regimens that require food and experience poorer treatment outcomes. Determination of optimal ART regimens should take patient access to food into account and treatment guidelines should explicitly highlight the importance of food access in selecting ART regimens.
authors.affiliation: University of Connecticut, Storrs, CT, USA seth.k@uconn.edu.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Washington
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Grebler
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Ginger
authors.initials: G
authors.lastname: Hoyt
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Brandi
authors.initials: B
authors.lastname: Welles
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Merely
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kegler
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
authors.affiliation: University of Connecticut, Storrs, CT, USA.
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D011307:Drug Prescriptions; D005260:Female; D005502:Food; D005523:Food Supply; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: disease management; health outcomes; health promotion; medications; primary care