title: Brief Report: Food Insufficiency Is Associated With Lack of Sustained Viral Suppression Among HIV-Infected Pregnant and Breastfeeding Ugandan Women.
abstract: Food insecurity is associated with poor virologic outcomes, but this has not been studied during pregnancy and breastfeeding. We assessed sustained viral suppression from 8 weeks on antiretroviral therapy to 48 weeks postpartum among 171 pregnant and breastfeeding Ugandan women; 74.9% experienced food insufficiency. In multivariable analysis, food insufficiency [adjusted odds ratio (aOR) 0.38, 95% confidence interval (CI): 0.16 to 0.91], higher pretreatment HIV-1 RNA (aOR 0.55 per 10-fold increase, 95% CI: 0.37 to 0.82), and lopinavir/ritonavir versus efavirenz (aOR 0.49, 95% CI: 0.24 to 0.96) were associated with lower odds of sustained viral suppression. Interventions to address food security may improve virologic outcomes among HIV-infected women.
authors.affiliation: *Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA; †Makerere University-University of California, San Francisco Research Collaboration, Kampala, Uganda; ‡Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA; §Medical Research Council Unit, The Gambia, Serrekunda, Gambia; ‖Department of Pediatrics, University of California, San Francisco, San Francisco, CA; ¶Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA; #Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; and **Department of Population Medicine and Diagnostic Sciences, Program in International Nutrition, Cornell University, Ithaca, NY.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Koss
authors.forename: Paul
authors.initials: P
authors.lastname: Natureeba
authors.forename: Dorcas
authors.initials: D
authors.lastname: Nyafwono
authors.forename: Albert
authors.initials: A
authors.lastname: Plenty
authors.forename: Julia
authors.initials: J
authors.lastname: Mwesigwa
authors.forename: Bridget
authors.initials: B
authors.lastname: Nzarubara
authors.forename: Tamara D
authors.initials: TD
authors.lastname: Clark
authors.forename: Theodore D
authors.initials: TD
authors.lastname: Ruel
authors.forename: Jane
authors.initials: J
authors.lastname: Achan
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Charlebois
authors.forename: Deborah
authors.initials: D
authors.lastname: Cohan
authors.forename: Moses R
authors.initials: MR
authors.lastname: Kamya
authors.forename: Diane V
authors.initials: DV
authors.lastname: Havlir
authors.forename: Sera L
authors.initials: SL
authors.lastname: Young
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding; D005260:Female; D005523:Food Supply; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents