Medical care and health outcomes of food and nutrition services for persons living with HIV/AIDS: Implications for maintenance in care and cost savings

Introduction. The purpose of this study is to investigate longitudinal patterns of food insecurity , receipt of food and nutrition services, and outcomes for engagement with HIV primary care and health of HIV-positive adults. Methods. Measures of food insecurity and use of food and nutrition services were collected by in-person interviews conducted between 2003 and 2010 for a cohort study of PLWHA residing in New York City (N=693) and the Tri-County suburban region north of the City (N=484). Results.Rates of food insecurity are high and at each interview period and more than half of the sample report relying on food assistance programs (e.g. group meals, food pantry). Persons who are food insecure are at risk for poor connection to HIV treatment. The odds of 2+ missed appointments for HIV medical care in the 6 mos prior to interview are twice as high for the food insecure as for others, controlling for wide range of personal, clinical, and service use characteristics(AOR 1.98, CI 11.4,2.8). However the food insecure who receive FN services and are no longer food insecure by 12 month followup interview are significantly less likely to report missed appointments during the follow up period compared to those with continuing food and nutritional needs (AOR 0.12, CI 0.021,0.69). Conclusion.Findings underscore the importance of integrating food and nutritional services with medical care and other services for PLWHA to improve maintenance in care and health outcomes and costs saving implications of incorporating effective food and nutritional services into models of care.