Online Program

Associations between frequent mental distress, perceived HIV stigma, and food insecurity among low-income HIV/AIDS patients: Implications for HIV care programs

Monday, November 2, 2015 : 9:10 a.m. - 9:30 a.m.

Marianna Wetherill, PhD, MPH, RDN-AP/LD, Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, College of Public Health, Tulsa, OK
Robert John, PhD, College of Public Health, Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Denna Wheeler, PhD, OSU Center for Rural Health, Oklahoma State University, Tulsa, OK
Andrew Moore, LPC, Infectious Diseases Institute, University of Oklahoma Health Sciences Center, Oklahoma City
Kathy Ackerman, RAIN Oklahoma, Oklahoma City, OK

Poor mental health, HIV stigma, and food insecurity are associated with HIV/AIDS risk behaviors and negative health outcomes. These conditions may cluster to produce patterns of social risk; however no published studies have explored the co-occurrence of frequent mental distress, perceived stigma, and food insecurity in resource-rich settings.


Participants were recruited at Ryan White service providers and were receiving both case management and medical care for HIV/AIDS (n = 164). Data were collected using a self-administered 66-item questionnaire containing standardized measures. Descriptive statistics, Chi square, t-tests, and Mantel-Haenszel odds ratios were calculated using SPSS 20.0.


Frequent mental distress (FMD) was common (n = 67, 40.9%).  Perceived stigma was higher among those with FMD (p = .008).  FMD was associated with greater degrees of food insecurity (FI) (p < .001) and patients with FMD had 3.5 times the odds of being food insecure, OR = 3.5, 95% CI = 1.7, 7.4. Those experiencing FMD and FI were more likely to endorse specific items on the stigma scale suggestive of social isolation.  One of four patients with FMD (24.6%) reported no current treatment for their mental health problems.


Often identified as a barrier to care entry, FMD is also common for patients receiving HIV medical care.  FMD was associated with higher rates of perceived HIV stigma and FI.  HIV medical and social service providers should implement routine mental health and food security screening strategies consistent with IOM recommendations, which may improve retention in care rates.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Explain the associated risks for food insecurity and perceived HIV stigma among HIV-positive patients experiencing frequent mental distress.

Keyword(s): Food Security, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have 10 years experience providing community-based HIV services for low-income individuals. My experience includes administration of Ryan White and HOPWA funded programs; state-wide quality improvement initiatives for the planning and delivery of Ryan White services; and evaluations of existing programs as they relate to retention in care initiatives. Additionally, I am a registered dietitian with practice experience in delivering nutrition services for food insecure individuals.
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.

Back to: 3045.0: HIV/AIDS and Mental Health