Browsing by Author "Frongillo, Edward A."

Now showing 1 - 4 of 4
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    Changes in Food Insecurity, Nutritional Status, and Physical Health Status After Antiretroviral Therapy Initiation in Rural Uganda
    (Journal of acquired immune deficiency syndromes, 2012) Weiser, Sheri D.; Gupta, Reshma; Tsai, Alexander C.; Frongillo, Edward A.; Grede, Nils; Kumbakumba, Elias; Kawuma, Annet; Hunt, Peter W.; Bangsberg, David R.; Martin, Jeffrey N.
    To investigate whether time on antiretroviral therapy (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status. The Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda. Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each 3-month period. Outcomes were food insecurity, nutritional status, and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and sociodemographic characteristics.
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    Food Insecurity and Sexual Risk in an HIV Endemic Community in Uganda
    (AIDS and Behavior, 2011) Miller, Cari L.; Bangsberg, David R.; Tuller, David M.; Senkungu, Jude; Kawuma, Annet; Frongillo, Edward A.; Weiser, Sheri D.
    Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged from the interview data: the relationship between food insecurity and transactional sex for women; the impact of a husband’s death from HIV on worsening food insecurity among women and children; the impact of food insecurity on control over condom use, and the relationship between food insecurity and staying in violent/abusive relationships. Food insecurity led to increased sexual vulnerability among women. Women were often compelled to engage in transactional sex or remain in violent or abusive relationships due to their reliance on men in their communities to provide food for themselves and their children. There is an urgent need to prioritize food security programs for women living with HIV/AIDS and address broader gender-based inequities that are propelling women to engage in risky sexual behaviors based on hunger. Such interventions will play an important role in improving the health and well being of people living with HIV/AIDS, and preventing HIV transmission
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    Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting
    (AIDS (London, England), 2012) Weiser, Sheri D.; Tsai, Alexander C.; Gupta, Reshma; Frongillo, Edward A.; Kawuma, Annet; Senkungu, Jude; Hunta, Peter W.; Emenyonue, Nneka I.; Mattson, Jennifer E.; Martin, Jeffrey N.; Bangsberg, David R.
    We undertook a longitudinal study in rural Uganda to understand the association of food insecurity with morbidity and patterns of healthcare utilization among HIV-infected individuals enrolled in an antiretroviral therapy program. Longitudinal cohort study. Participants were enrolled from the Uganda AIDS Rural Treatment Outcomes cohort, and underwent quarterly structured interviews and blood draws. The primary predictor was food insecurity measured by the validated Household Food Insecurity Access Scale. Primary outcomes included health-related quality of life measured by the validated Medical Outcomes Study-HIV Physical Health Summary (PHS), incident self-reported opportunistic infections, number of hospitalizations, and missed clinic visits. To estimate model parameters, we used the method of generalized estimating equations, adjusting for sociodemographic and clinical variables. Explanatory variables were lagged by 3 months to strengthen causal interpretations.
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    Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda
    (AIDS (London, England), 2014) Weiser, Sheri D.; Palar, Kartika; Frongillo, Edward A.; Tsai, Alexander C.; Kumbakumba, Elias; dePee, Saskia; Hunta, Peter W.; Ragland, Kathleen; Martin, Jeffrey; Bangsber, David R.
    Food insecurity is a potentially important barrier to the success of antiretroviral therapy (ART) programs in resource-limited settings. We undertook a longitudinal study in rural Uganda to estimate the associations between food insecurity and HIV treatment outcomes. Longitudinal cohort study. Participants were from the Uganda AIDS Rural Treatment Outcomes study and were followed quarterly for blood draws and structured interviews. We measured food insecurity with the validated Household Food Insecurity Access Scale. Our primary outcomes were: ART nonadherence (adherence <90%) measured by visual analog scale; incomplete viral load suppression (>400 copies/ml); and low CD4þ T-cell count (<350 cells/ml). We used generalized estimating equations to estimate the associations, adjusting for socio-demographic and clinical variables.