Food Insecurity, Dietary Diversity, and Body Mass Index of HIV-Infected Individuals on Antiretroviral Therapy in Rural Haiti.
Food rations are increasingly offered as part of HIV programs in resource-poor settings, often targeted solely to those with under-nutrition by low body mass index (BMI). This practice does not consider food insecurity, another important risk factor for poor outcomes in people living with HIV/AIDS (PLWH). We analyzed factors associated with low BMI and severe food insecurity in 523 PLWH receiving antiretroviral therapy in rural Haiti using logistic regression. Food insecurity was present in 89 % of individuals. Among those with severe food insecurity, 86 % had a BMI ≥ 18.5 kg/m(2). Severe food insecurity was associated with illiteracy [adjusted odds ratio (AOR) 1.79, p = 0.005], having no income (AOR 1.58, p = 0.04), and poverty (p < 0.001). Compared with those with little to no food insecurity, individuals with severe food insecurity had a less diverse diet. We found that food insecurity was highly prevalent in PLWH receiving antiretroviral therapy in rural Haiti. Using BMI as a sole criterion for food supplementation in HIV programs can exclude highly vulnerable individuals who may benefit from such support.
Division of Infectious Diseases, SUNY Downstate Medical Center, MSC 1240, 450 Clarkson Avenue, Brooklyn, NY, 11231, USA. gabriel.rebick@downstate.edu.|Department of Medicine, State University of New York-Downstate, Brooklyn, NY, USA. gabriel.rebick@downstate.edu.
Gabriel W
GW
Rebick
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.|Partners In Health, Boston, MA, USA.
Molly F
MF
Franke
Partners In Health, Boston, MA, USA.|Department of Medicine, Brigham and Women's Hospital, 641 Huntington Ave, 4th Floor, Boston, MA, USA.
Jessica E
JE
Teng
Partners In Health, Boston, MA, USA.|Zanmi Lasante, Saint Marc, Haiti.
J
J
Gregory Jerome
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. livers@pih.org.|Partners In Health, Boston, MA, USA. livers@pih.org.|Department of Medicine, Brigham and Women's Hospital, 641 Huntington Ave, 4th Floor, Boston, MA, USA. livers@pih.org.
Louise C
LC
Ivers
D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D015992:Body Mass Index; D004032:Diet / Q000208:ethnology / Q000523:psychology; D005523:Food Supply / Q000191:economics; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000208:ethnology; D006205:Haiti; D006801:Humans; D007182:Income; D008297:Male; D044342:Malnutrition / Q000209:etiology; D009752:Nutritional Status; D011204:Poverty Areas; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult
Food insecurity; Food security; HIV; Macronutrient supplement; Nutrition