The Association Between Food Insufficiency and HIV Treatment Outcomes in a Longitudinal Analysis of HIV-Infected Individuals in New York City
The Association Between Food Insufficiency and HIV Treatment Outcomes in a Longitudinal Analysis of HIV-Infected Individuals in New York City
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DOI：
10.1097/qai.0000000000000596
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发表时间：
2015-07-01
影响因子：
3.6
通讯作者：
Irvine, Mary K.
中科院分区：
文献类型：
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作者：
Feldman, Matthew B.;Alexy, Emily R.;Irvine, Mary K.
背景：迄今为止，很少有关于艾滋病毒感染者（PLWH）粮食不安全的纵向研究。粮食不足是粮食不安全概念的一个方面，指的是个人由于资源有限而食物摄入量不足的时期。本分析的目的是研究纽约市（NYC）HIV感染者中FI和HIV治疗结果之间的关系。FI之间的关联（在最近2次评估中均出现食物不一致，在最近2次评估中有1次出现食物不一致，或均未出现）和HIV疾病进展的临床指标（病毒载量> 200拷贝/毫升，CD 4计数< 200个细胞/立方毫米）对与纽约市艾滋病毒监测登记处匹配并在2011年11月至2012年11月期间完成2次FI评估的纽约市Ryan白色A部分食品和营养计划客户进行了分析结果：在2,118名参与食品和营养项目的艾滋病毒携带者中，61%的人经历了一致的FI，25%的人经历了不一致的FI。在控制社会人口学特征的多变量分析中，一致的FI与未抑制的病毒载量独立相关（校正比值比= 1.6，置信区间：1.1至2.5）。一致的FI仅与低CD 4计数在bivariate level.Conclusions：未来的研究应检查生物，结构和心理社会因素，可以解释FI和HIV治疗结果之间的关系，告知干预措施的发展。食品和营养计划客户中持续的FI表明，需要提供服务，以满足艾滋病毒携带者对财务稳定的潜在需求（例如，职业咨询）。
Background:To date, there have been few longitudinal studies of food insecurity among people living with HIV (PLWH). Food insufficiency (FI) is one dimension of the food insecurity construct that refers to periods of time during which individuals have an inadequate amount of food intake because of limited resources. The aim of this analysis was to examine the relationship between FI and HIV treatment outcomes among HIV-infected individuals in New York City (NYC).Methods:Associations between FI (consistentfood insufficient on both of the last 2 assessments, inconsistentfood insufficient on 1 of the last 2 assessments, or neither) and clinical indicators of HIV disease progression (viral load > 200 copies per milliliter, CD4 count < 200 cells per cubic millimeter) were analyzed for NYC Ryan White Part A food and nutrition program clients who were matched to the NYC HIV Surveillance Registry and completed 2 FI assessments between November 2011 and June 2013.Results:Among 2,118 PLWH in food and nutrition programs, 61% experienced consistent FI and 25% experienced inconsistent FI. In multivariate analyses controlling for sociodemographic characteristics, consistent FI was independently associated with unsuppressed viral load (adjusted odds ratio = 1.6, confidence interval: 1.1 to 2.5). Consistent FI was only associated with low CD4 counts at the bivariate level.Conclusions:Future studies should examine biological, structural, and psychosocial factors that may explain the relationship between FI and HIV treatment outcomes to inform intervention development. Persistent FI among food and nutrition program clients suggests that services are needed to address underlying needs for financial stability (eg, vocational counseling) for PLWH.