Online Program

Food insecurity is associated with HIV serostatus among low income adults in the national health and nutrition examination survey (NHANES) (1999-2008)

Tuesday, November 5, 2013 : 1:00 p.m. - 1:15 p.m.

Kartika Palar, PhD, School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
Barbara A. Laraia, PhD, MPH, RD, School of Public Health, University of California, Berkeley, Berkeley, CA
Sheri Weiser, MD, MPH, Division of HIV/AIDS, Department of Medicine, University of California at San Francisco, San Francisco, CA
Background: Food insecurity is associated with risky sexual practices and sexual violence in multiple studies, suggesting a link to HIV acquisition. Yet no population-based studies have examined the association between food insecurity and HIV serostatus. Methods: We conducted a cross-sectional analysis of the nationally representative, population-based National Health and Nutrition Examination Survey (NHANES) (1999-2008). We included participants ages 18 to 49 with incomes under 300% of the federal poverty line. The primary outcome, HIV serostatus, was assessed via blood test conducted during the NHANES examination. Household food security was measured using a validated scale developed by the US Department of Agriculture and individuals were dichotomized as having low or very low food security (“severe food insecurity”) versus all other categories. Analyses were adjusted for sex, age, race, marital status, household size, income, and education, and utilized appropriate design weights and complex survey commands. Results: We analyzed data for 8,991 participants, representing approximately 63 million non-institutionalized individuals in the US. HIV prevalence was 1.28% among those with severe food insecurity compared to 0.50% among those with full or marginal food security (p<0.01). Severe food insecurity was associated with over 2 times increased odds of HIV seropositivity [AOR = 2.42; 95% CI 1.06 - 5.57] in adjusted analyses. Conclusions: Household food insecurity is associated with HIV serostatus among low-income Americans. Improving access to food and participation in safety net programs may play a role in reducing HIV risk, but further research is needed to establish the causal relationship and direction.

Learning Areas:

Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess the association between food insecurity and HIV serostatus among low income individuals in the United States

Keyword(s): Food Security, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a postdoctoral fellow working on social and economic issues related to HIV prevention and treatment, with a focus on food security and nutrition. I have published several peer-reviewed articles on this topic and am engaged in a range of both observational and intervention-based research projects in this area, domestically and internationally.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.