title: Food Insecurity in HIV-Hepatitis C Virus Co-infected Individuals in Canada: The Importance of Co-morbidities.
abstract: While research has begun addressing food insecurity (FI) in HIV-positive populations, knowledge regarding FI among individuals living with HIV-hepatitis C virus (HCV) co-infection is limited. This exploratory study examines sociodemographic, socioeconomic, behavioral, and clinical factors associated with FI in a cohort of HIV-HCV co-infected individuals in Canada. We analyzed longitudinal data from the Food Security and HIV-HCV Co-infection Study of the Canadian Co-infection Cohort collected between November 2012-June 2014 at 15 health centres. FI was measured using the Household Food Security Survey Module and classified using Health Canada criteria. Generalized estimating equations were used to assess factors associated with FI. Among 525 participants, 59 % experienced FI at their first study visit (baseline). Protective factors associated with FI (p < 0.05) included: enrolment at a Quebec study site (aOR: 0.42, 95 % CI: 0.27, 0.67), employment (aOR: 0.55, 95 % CI: 0.35, 0.87), and average personal monthly income (aOR per $100 CAD increase: 0.98, 95 % CI: 0.97, 0.99). Risk factors for FI included: recent injection drug use (aOR: 1.98, 95 % CI: 1.33, 2.96), trading away food (aOR: 5.23, 95 % CI: 2.53, 10.81), and recent experiences of depressive symptoms (aOR: 2.11, 95 % CI: 1.48, 3.01). FI is common in this co-infected population. Engagement of co-infected individuals in substance use treatments, harm reduction programs, and mental health services may mitigate FI in this vulnerable subset of the HIV-positive population.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada. joseph.cox@mcgill.ca.|Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada. joseph.cox@mcgill.ca.|CIHR Canadian HIV Trials Network, Vancouver, BC, Canada. joseph.cox@mcgill.ca.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cox
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hamelin
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
authors.forename: Taylor
authors.initials: T
authors.lastname: McLinden
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
authors.forename: Erica E M
authors.initials: EE
authors.lastname: Moodie
authors.affiliation: Department of Pediatrics, Harvard Medical School, Boston, MA, USA.|Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Aranka
authors.initials: A
authors.lastname: Anema
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Rollet-Kurhajec
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
authors.forename: Gilles
authors.initials: G
authors.lastname: Paradis
authors.affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.|The Ontario HIV Treatment Network, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Sean B
authors.initials: SB
authors.lastname: Rourke
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.|Division of Infectious Diseases, University Health Network, Toronto, ON, Canada.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Walmsley
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
mesh_terms: D000328:Adult; D002170:Canada; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D055815:Young Adult
keywords: Canada; Co-infection; Food insecurity; HCV; HIV