Prevalence and predictors of food insecurity among people living with and without HIV in the African Cohort Study
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Public Health Nutrition
Abstract
We determined the prevalence and identified predictors of food insecurity
in four African countries.
Design: Cross-sectional analyses at study enrolment.
Setting: From January 2013 to March 2020, people living with HIV (PLWH) and
without HIV were enrolled at twelve clinics in Kenya, Uganda, Tanzania and
Nigeria.
Participants: Participants reporting not having enough food to eat over the past 12
months or receiving <3 meals/d were defined as food insecure. Robust Poisson
regression models were used to estimate unadjusted and adjusted prevalence
ratios (aPR) and 95 % CI for predictors of food insecurity among all participants
and separately among PLWH.
Results: 1694/3496 participants (48·5 %) reported food insecurity at enrolment,
with no difference by HIV status. Food insecurity was more common among older
participants (50þ v. 18–24 years aPR 1·35, 95 % CI 1·15, 1·59). Having 2–5 (aPR
1·14, 95 % CI 1·01, 1·30) or >5 dependents (aPR 1·17, 95 % CI 1·02, 1·35), and residing
in Kisumu West, Kenya (aPR 1·63, 95 % CI 1·42, 1·87) or Nigeria (aPR 1·20, 95 %
CI 1·01, 1·41) was associated with food insecurity. Residing in Tanzania (aPR 0·65,
95 % CI 0·53, 0·80) and increasing education (secondary/above education v. none/
some primary education aPR 0·73, 95 % CI 0·66, 0·81) was protective against food
insecurity. Antiretroviral therapy (ART)-experienced PLWH were more likely to be
food secure irrespective of viral load.
Conclusion: Food insecurity was highly prevalent in our cohort though not significantly
associated with HIV. Policies aimed at promoting education, elderly care,
ART access in PLWH and financial independence could potentially improve food
security in Africa.
Description
Keywords
Food insecurity, HIV, Antiretroviral therapy, Africa, Food supply, Nutrition policy
Citation
Onyenakie, C. C., Nnakwe, R. U., Dear, N., Esber, A., Bahemana, E., Kibuuka, H., ... & Iroezindu, M. (2022). Prevalence and predictors of food insecurity among people living with and without HIV in the African Cohort Study. Public Health Nutrition, 25(4), 930-943.