title: Association Between Food Insecurity and HIV Viral Suppression: A Systematic Review and Meta-Analysis.
abstract: Although an increasing number of HIV infected people are accessing antiretroviral treatment, many do not achieve complete HIV viral suppression and remain at risk for AIDS and capable of HIV transmission. Food insecurity has been identified as a potential risk factor for poor virologic response, but the association between these factors has been inconsistently documented in the literature. We systematically searched five electronic databases and bibliographies of relevant studies through April 2015 and retrieved 11 studies that met our inclusion criteria, of which nine studies were conducted in North America and the remaining two studies were in Brazil and Uganda respectively. Meta-analyzed results indicated that experiencing food insecurity resulted in 29% lower odds of achieving complete HIV viral suppression (OR = 0.71, 95% CI 0.61-0.82) and this significant inverse association was consistently found regardless of study design, exposure measurement, and confounder adjustment methods. These findings suggest that food insecurity is a potential risk factor for incomplete HIV viral suppression in people living with HIV.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: Wusiman
authors.initials: W
authors.lastname: Aibibula
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.|Public Health Department, CIUSSS du Centre-Est-de-l 'Ile-de-Montréal, Montréal, QC, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cox
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hamelin
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: Taylor
authors.initials: T
authors.lastname: McLinden
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.|Department of Medicine, McGill University, Montreal, QC, Canada.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. paul.brassard@mcgill.ca.|Department of Medicine, McGill University, Montreal, QC, Canada. paul.brassard@mcgill.ca.|Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada. paul.brassard@mcgill.ca.|Centre for Clinical Epidemiology, Jewish General Hospital, 3755 Cote Sainte-Catherine, Pavilion H 424.1, Montreal, QC, H3T 1E2, Canada. paul.brassard@mcgill.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Brassard
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001938:Brazil; D003431:Cross-Cultural Comparison; D005523:Food Supply / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D009656:North America; D013223:Statistics as Topic; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents
keywords: Food insecurity; HIV; Meta-analysis; Viral suppression