Food Insecurity Is Associated With a Lower Quality of Life Among People Living With HIV (PLWH) and HIV Seronegative Individuals, in the Miami Adult Studies on HIV (MASH) Cohort

Abstract

ObjectivesFood insecurity affects underserved and marginalized populations in the United States, which could lead to a decline in quality of life over time and further worsening health outcomes. This study aims to determine the association between food security and quality of life among people living with and without HIV in Miami, FL. MethodsThis was a cross-sectional analysis of a minority population from the Miami Adult Studies on HIV (MASH) cohort. Demographics, anthropometrics, and fasting blood samples were collected by trained personnel. HIV viral loads (VL, copies/ml) were abstracted from medical records (suppressed viral load < 50 copies/ml) with the participants’ consent. Food security status was assessed using the USDA Household Food Security Module and analyzed as food secure (full) vs. insecure (marginal, low, very low). Quality of Life (QoL) was determined with the Spitzer QoL Index (scores: 0–10). QoL was dichotomized as a high (≥8) or low QoL (<8). All statistical analyses were performed using SPSS 26. ResultsParticipants’ mean age was 54.6 ± 7.9 years (N = 1,034), 58% were male, and 61.1% Black; 46.6% were living with HIV and 90.9% had a suppressed viral load. Food insecurity was reported by 48.4% of individuals. Food secure individuals showed a significantly higher QoL score compared to food insecure individuals (8.68 ± 1.57, 7.84 ± 1.89, respectively; p < 0.001). People living with HIV (PLWH) did not have significantly different QoL scores nor food insecurity compared to HIV-uninfected individuals. A linear regression showed that food security was associated with higher QoL after adjusting for age, sex, race, ethnicity, HIV status, BMI, and annual family income (β = 0.64 SE = 0.11, P = 0.001). Logistic regression found that food insecurity was associated with lower odds of having a high QoL after adjusting for age, sex, race and ethnicity, HIV status, BMI, and annual family income (OR: 0.45; 95% CI: 0.33, 0.62; P < 0.001). ConclusionsFood insecurity negatively affects the quality of life of minorities with and without HIV in the MASH cohort in Miami. Improving the food security of marginalized populations by facilitating their access to high-quality foods could improve their health and quality of life. Funding SourcesNational Institute on Drug Abuse.