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Abstract
BackgroundFood insecurity is associated with poor nutritional and clinical outcomes among people living with HIV/AIDS. Few studies investigate the link between food insecurity, dietary diversity and health-related quality of life among people living with HIV/AIDS.ObjectiveWe investigated whether household food access and individual dietary diversity are associated with health-related quality of life among people living with HIV/AIDS in Uganda.MethodsWe surveyed 902 people living with HIV/AIDS and their households from two clinics in Northern Uganda. Health-related quality of life outcomes were assessed using the Medical Outcomes Study (MOS)-HIV Survey. We performed multivariate regressions to investigate the relationship between health-related quality of life, household food insecurity and individual dietary diversity.ResultsPeople living with HIV/AIDS from severe food insecurity households have mean mental health status scores that are 1.7 points lower (p<.001) and physical health status scores that are 1.5 points lower (p<.01). Individuals with high dietary diversity have mean mental health status scores that were 3.6 points higher (p<.001) and physical health status scores that were 2.8 points higher (p<.05).ConclusionsFood access and diet quality are associated with health-related quality of life and may be considered as part of comprehensive interventions designed to mitigate psychosocial consequences of HIV.
Highlights
Food access and diet quality are associated with health-related quality of life and may be considered as part of comprehensive interventions designed to mitigate psychosocial consequences of HIV
Among people living with HIV (PLHIV), health related quality of life (HRQoL) is important in the management of the disease, due to its chronic nature and the disease’s myriad mental, emotional and physical manifestations over its course
Food insecurity is recognized as fundamental to the four core pillars of a holistic response against HIV–prevention, care, treatment and mitigation [16,17,18]. It is strongly associated with increased behavioral risk of HIV transmission [16,19,20,21,22], reduced access to HIV treatment and care [16], decreased adherence to antiretroviral therapy (ART) [21,23], poor nutritional status [24], and worse clinical outcomes among HIV-infected individuals [22,25,26]; and relatedly, clinical fasting is associated with adverse antiretroviral pharmacokinetics [27,28]
Summary
Among people living with HIV (PLHIV), health related quality of life (HRQoL) is important in the management of the disease, due to its chronic nature and the disease’s myriad mental, emotional and physical manifestations over its course. Defined as ‘‘the limited or uncertain availability of nutritionally adequate, safe foods or the inability to acquire personally acceptable foods in socially acceptable ways,’’ [9], food insecurity is linked to adverse health outcomes, including cardiovascular risk factors and diabetes [10], poor self-reported health [11,12], and nutrient inadequacy [13]. It is associated with lower HRQoL in general populations and among those with chronic disease or disability [12,14,15]. Few studies investigate the link between food insecurity, dietary diversity and health-related quality of life among people living with HIV/AIDS
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