title: Association between Food Insecurity and Procurement Methods among People Living with HIV in a High Resource Setting.
abstract: OBJECTIVE
  People living with HIV in high-resource settings suffer severe levels of food insecurity; however, limited evidence exists regarding dietary intake and sub-components that characterize food insecurity (i.e. food quantity, quality, safety or procurement) in this population. We examined the prevalence and characteristics of food insecurity among people living with HIV across British Columbia, Canada.
  
  
  METHODS
  This cross-sectional analysis was conducted within a national community-based research initiative.
  
  
  METHODS
  Food security was measured using the Health Canada Household Food Security Scale Module. Logistic regression was used to determine key independent predictors of food insecurity, controlling for potential confounders.
  
  
  RESULTS
  Of 262 participants, 192 (73%) reported food insecurity. Sub-components associated with food insecurity in bivariate analysis included: < RDI consumption of protein (p = 0.046); being sick from spoiled/unsafe food in the past six months (p = 0.010); and procurement of food using non-traditional methods (p <0.05). In multivariable analyses, factors significantly associated with food insecurity included: procurement of food using non-traditional methods [AOR = 11.11, 95% CI: 4.79-25.68, p = <0.001]; younger age [AOR = 0.92, 95% CI: 0.86-0.96, p = <0.001]; unstable housing [AOR = 4.46, 95% CI: 1.15-17.36, p = 0.031]; household gross annual income [AOR = 4.49, 95% CI: 1.74-11.60, p = 0.002]; and symptoms of depression [AOR = 2.73, 95% CI: 1.25-5.96, p = 0.012].
  
  
  CONCLUSIONS
  Food insecurity among people living with HIV in British Columbia is characterized by poor dietary quality and food procurement methods. Notably, participants who reported procuring in non-traditional manners were over 10 times more likely to be food insecure. These findings suggest a need for tailored food security and social support interventions in this setting.
authors.affiliation: Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America.|Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America.|Division of International Nutrition, Department of Food, Nutrition and Health, Faculty of Land and Food Systems University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Aranka
authors.initials: A
authors.lastname: Anema
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Fielden
authors.affiliation: HIV/AIDS Drug Treatment Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Shurgold
authors.affiliation: HIV/AIDS Drug Treatment Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Ding
authors.affiliation: Immune Deficiency Clinic, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Messina
authors.affiliation: Pacific AIDS Network, Vancouver, British Columbia, Canada.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Jones
authors.affiliation: AIDS Vancouver, Vancouver, British Columbia, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Chittock
authors.affiliation: Coalition des organismes communautaires québécois de lutte contre le sida, Montréal, Quebéc, Canada.
authors.forename: Ken
authors.initials: K
authors.lastname: Monteith
authors.affiliation: Ontario HIV Treatment Network, Toronto, Ontario, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Globerman
authors.affiliation: Ontario HIV Treatment Network, Toronto, Ontario, Canada.|Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sean B
authors.initials: SB
authors.lastname: Rourke
authors.affiliation: HIV/AIDS Drug Treatment Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Faculty of Health Sciences, Simon Fraser University; Burnaby, British Columbia, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000379:methods* / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009753:Nutritive Value; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors