Social determinants, lived experiences, and consequences of household food insecurity among persons living with HIV/AIDS on the shore of Lake Victoria, Kenya

Jason M Nagata, Richard O Magerenge, Sera L Young, Joel O Oguta, Sheri D Weiser, Craig R Cohen, Jason M Nagata, Richard O Magerenge, Sera L Young, Joel O Oguta, Sheri D Weiser, Craig R Cohen

Abstract

Food insecurity is a considerable challenge in sub-Saharan Africa, disproportionately affecting persons living with HIV/AIDS. This study investigates the lived experience, determinants, and consequences of food insecurity and hunger among individuals living with HIV/AIDS on the shore of Lake Victoria in Suba District, Kenya. Parallel mixed methods included semi-structured interviews and administration of the Household Food Insecurity Access Scale among a systematic sample of 67 persons living with HIV/AIDS (49 of whom were receiving antiretroviral therapy [ART]). All respondents were either severely (79.1%) or moderately (20.9%) food insecure; no respondents were mildly food insecure or food secure. Qualitative data and simple and multiple linear regression models indicated that significant determinants of food insecurity include increased age, a greater number of children, and not being married. A number of themes related to food insecurity and ART emerged, including: (1) an increase in hunger or appetite since initiating ART; (2) exacerbation of ART-related side effects; and (3) non-adherence to ART due to hunger, food insecurity, or agricultural work responsibilities. HIV interventions should address food insecurity and hunger, particularly among at-risk populations, to promote ART adherence and better health outcomes.

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Determinants and consequences of household food insecurity in SubaDistrict, Kenya

References

    1. Bukusuba J, Kikafunda J, Whitehead R. Food security status in households of people living with HIV/AIDS (PLWHA) in a Ugandan urban setting. British Journal of Nutrition. 2007;98:211–217.
    1. Chaput S, Gilbert J, Tremblay A. Relationship between food insecurity and body composition in Ugandans living in urban Kampala. Journal of the American Dietetic Association. 2007;107:1978–1982.
    1. Coates J, Frongillo E, Rogers B, Webb P, Wilde P, Houser R. Commonalities in the experience of household food insecurity across cultures: what are measures missing? Journal of Nutrition. 2006;136(5):1438S–1448S.
    1. Coates J, Swindale A, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guide (v. 3) Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development; 2007.
    1. Creswell J, Plano Clark V, Gutmann M, Hanson W. Advanced mixed methods research designs. In: Tashakkori A, Teddlie C, editors. Handbook of Mixed Methods in Social and Behavioral Research. Thousand Oaks, CA: Sage; 2003.
    1. Cutrona C. Social support in couples: marriage as a resource in times of stress. Thousand Oaks, CA: Sage; 1996.
    1. FAO. The State of Food Insecurity in the World. Rome: Food and Agriculture Organization; 2010.
    1. Fenton L. Preventing HIV/AIDS through poverty reduction: the only sustainable solution. Lancet. 2005;364(9440):1186–1187.
    1. Foley W, Ward P, Carter P, Coveney J, Tsourtos G, Taylor A. An ecological analysis of factors associated with food insecurity in South Australia, 2002-7. Public Health Nutrition. 2010;13(2):215–221.
    1. Frongillo E, Nanama S. Development and validation of an experience-based measure of household food insecurity within and across seasons in Northern Burkina Faso. Journal of Nutrition. 2006;136(5):1409S–1419S.
    1. Gillespie S, Kadiyala S. HIV/AIDS and food and nutrition security: from evidence to action. Washington, DC: International Food Policy Research Institute; 2005.
    1. Haddad L, Gillespie S. Effective food and nutrition policy responses to HIV/AIDS: what we know and what we need to know. Journal of International Development. 2001;13(4):487–511.
    1. Hanson K, Sobal J, Frongillo E. Gender and marital status clarify associations between food insecurity and body weight. Journal of Nutrition. 2007;137(6):1460–1465.
    1. Ivers L, Cullen K, Freedberg K, Block S, Coates J, Webb P. HIV/AIDS, undernutrition, and food insecurity. Clinical Infectious Diseases. 2009;49(7):1092–1102.
    1. Johns T, Kokwaro J. Food plants of the Luo of Siaya District, Kenya. Economic Botany. 1991;45(1):103–113.
    1. Knueppel D, Demment M, Kaiser L. Validation of the Household Food Insecurity Access Scale in rural Tanzania. Public Health Nutrition. 2010;13(3):360–367.
    1. Laraia B, Siega-Riz A, Gunderson C, Dole N. Psychosocial factors and socioeconomic indicators are associated with household food insecurity among pregnant women. Journal of Nutrition. 2006;136(1):177–182.
    1. Lartey A. Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions. Proceedings of the Nutrition Society. 2008;67(1):105–108.
    1. Leyna G, Mmbaga E, Mnyika K, Hussain A, Klepp K. Food insecurity is associated with food consumption patterns and anthropometric measures but not serum micronutrient levels in adults in rural Tanzania. Public Health Nutrition. 2010;13(9):1438–1444.
    1. Light A. Gender differences in the marriage and cohabitation income premium. Demography. 2004;41(2):263–284.
    1. Lingard L, Albert M, Levinson W. Grounded theory, mixed methods, and action research. British Medical Journal. 2008;337:a567.
    1. Mamlin J, Kimaiyo S, Lewis S, Tadayo H, Jerop F, Gichunge C, Einterz R. Integrating nutrition support for food-insecure patients and their dependents into an HIV care and treatment program in Western Kenya. American Journal of Public Health. 2009;99(2):215–221.
    1. Melgar-Quinonez H, Zubieta A, MkNelly B, Nteziyaremye A, Gerardo M, Dunford C. Household food insecurity and food expenditure in Bolivia, Burkina Faso, and the Philippines. Journal of Nutrition. 2006;136(5):1420S–1430S.
    1. Mohammadzadeh A, Dorosty A, Eshraghian M. Household food security status and associate factors among high-school students in Esfahan, Iran. Public Health Nutrition. 2010;13(10):1609–1613.
    1. Mwaniki A. Achieving food security in Africa – Challenges and Issues, from >. (2006, 24 August 2010)
    1. Nagata J, Jew A, Kimeu J, Salmen C, Bukusi EC, Cohen CR. Medical pluralism on Mfangano Island: Use of medicinal plants among persons living with HIV/AIDS in Suba District, Kenya. Journal of Ethnopharmacology. 2011;135(2):501–509.
    1. NASCOP. National AIDS and STI Control Program. Nairobi: Ministry of Health; 2005. Sentinel Surveillance of HIV and STDs in Kenya.
    1. Strauss A, Corbin J. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: Sage; 1998.
    1. Swindale A, Bilinsky P. Development of a universally applicable household food insecurity measurement tool: process, current status, and outstanding issues. Journal of Nutrition. 2006;136(5):1449S–1452S.
    1. Townsend M, Peerson J, Love B, Achterberg C, Murphy S. Food insecurity is positively related to overweight in women. Journal of Nutrition. 2001;131(6):1738–1745.
    1. UNAIDS. UNAIDS Report on the Global AIDS Epidemic 2010. Geneva: Joint United Nations Programme on HIV/AIDS; 2010.
    1. Vosoris N, Tarasuk V. Household food insufficiency is associated with poorer health. Journal of Nutrition. 2003;133(1):120–126.
    1. Waite L. Does marriage matter? Demography. 1995;32:483–507.
    1. Webb P, Coates J, Frongilo E, Rogers B, Swindale A, Bilinsky P. Measuring household food insecurity: why it’s so important and yet so difficult to do. Journal of Nutrition. 2006:1404S–1408S.
    1. Weiser S, Bangsberg D, Kegeles S, Ragland K, Kushel M, Frongillo E. Food insecurity among homeless and marginally housed individuals living with HIV/AIDS in San Francisco. AIDS and Behavior. 2009b;13(5):841–848.
    1. Weiser S, Frongillo E, Ragland K, Hogg R, Riley E, Bangsberg D. Food Insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. Journal of General Internal Medicine. 2009a;24(1):14–20.
    1. Weiser S, Leiter K, Bangsberg D, Butler L, Pery-de Korte F, Phaladze N, Heisler M. Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland. PLoS Medicine. 2007;4:1589–1597.
    1. Weiser S, Tuller D, Frongillo E, Senkungu J, Mukiibi N, Bangsberg D. Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PloS One. 2010;5(4):e10340.

Source: PubMed

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