Food Insecurity among HIV-Infected women on antiretroviral treatment in Alabama's Black Belt

BACKGROUND: Little is known about food insecurity among HIV-infected women in the rural south. In this study we assess the prevalence and factors associated with food insecurity among a cohort of HIV-infected women on antiretroviral treatment Alabama's Black Belt. METHODS: A survey was conducted using a structured questionnaire among 295 HIV-infected women on antiretroviral treatment attending two clinics that provide medical and social support services to HIV-positive persons. Food insecurity was measured using the six-item United States Department of Agriculture Household Food Security Scale. We performed regression analysis to determine independent predictors of food insecurity. RESULTS: Among the 295 participants, more than half (51%) are food insecure. Multivariate analysis indicated that women with less education, less income, receiving food stamps, and had depressive symptoms were more likely to be food insecure. Results also indicated that these variables explained a small amount of the variance in food insecurity (R2 = 0.195). Conclusions: Food insecurity is prevalent among HIV-infected women on antiretroviral treatment in Alabama's Black Belt and the occurrence of food insecurity is more than three times higher than in the general U.S. population. The results suggest that screening for food insecurity and mental health should be critical components of HIV prevention and treatment. Understanding the correlates of food insecurity is important in identifying HIV-infected individuals at risk of malnutrition and other negative health outcomes. Appropriate programs and policies should be developed to address food insecurity in this population.