title: The Daily Relationship Between Aspects of Food Insecurity and Medication Adherence Among People Living with HIV with Recent Experiences of Hunger.
abstract: Limited access to resources can significantly impact health behaviors. Previous research on food insecurity and HIV has focused on establishing the relationship between lacking access to nutritious food and antiretroviral (ARV) medication non-adherence in a variety of social contexts.
  
  
  
  This study aims to determine if several aspects of food insecurity co-occur with missed doses of medication on a daily basis among a sample of people living with HIV who have recently experienced hunger.
  
  
  
  The current study utilized a prospective, observational design to test the daily relationship between food insecurity and medication non-adherence. Participants were followed for 45 days and completed daily assessments of food insecurity and alcohol use via interactive text message surveys and electronic medication adherence monitoring using the Wisepill.
  
  
  
  Fifty-nine men and women living with HIV contributed a total of 2,655 days of data. Results showed that severe food insecurity (i.e., hunger), but not less severe food insecurity (i.e., worrying about having food), significantly predicted missed doses of medication on a daily level. Daily alcohol use moderated this relationship in an unexpected way; when individuals were hungry and drank alcohol on a given day, they were less likely to miss a dose of medication.
  
  
  
  Among people living with HIV with recent experiences of hunger, this study demonstrates that there is a daily relationship between hunger and non-adherence to antiretroviral therapy. Future research is needed to test interventions designed to directly address the daily relationship between food insecurity and medication non-adherence.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. jennifer_pellowski@brown.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Pellowski
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cherry
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Conway-Washington
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Grebler
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, CT, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Krug
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D005523:Food Supply; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D006815:Hunger / Q000502:physiology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011203:Poverty; D011446:Prospective Studies; D060145:Text Messaging
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; Alcohol use; Food insecurity; HIV/AIDS; Multilevel modeling