REVIEW PAPER
Food security among people living with HIV: a review of programs and evidence in resource-limited settings
 
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Submission date: 2016-07-27
 
 
Final revision date: 2017-11-06
 
 
Acceptance date: 2017-11-17
 
 
Publication date: 2018-03-13
 
 
HIV & AIDS Review 2018;17(1):1-7
 
KEYWORDS
TOPICS
ABSTRACT
Food insecurity, which is prevalent among people living with human immunodeficiency virus (PLHIV), predicts poor treatment and health outcomes. In resource-limited settings, various programs have been implemented to improve access to food and mitigate adverse effects. This study aims to review existing food security programs and assess their evidence of effectiveness in improving food security, medication adherence, and other health outcomes of PLHIV in resource-limited settings. We conducted a review of the published literature on food security and HIV. We narrowed our review of food security programs to interventions that had been implemented in resource-limited settings. Programs can be classified into three categories – food assistance, livelihood development, and combined food assistance and livelihood support. Programs have varying degrees of feasibility and sustainability. The three programs also differ in terms of available empirical evidence to support effectiveness. Of the three categories, food assistance is the most evaluated program, followed by livelihood development and combined food and livelihood support. Current programs offer promising results in increasing access to food and improving key treatment and health outcomes, including adherence to antiretroviral therapy and nutrition. Future programmatic interventions should be appropriate and relevant to the needs and characteristics of PLHIV and their local contexts. Future programs, particularly those that provide livelihood assistance, also need to be rigorously evaluated to increase what we know about impacts on food security, medication adherence, and other health outcomes.
REFERENCES (45)
1.
Food and Agriculture Organization. Rome Declaration on World Food Security and World Food Summit Plan of Action. Rome, Italy: Food and Agriculture Organization of the United Nations; 1996.
 
2.
Musumari PM, Wouters E, Kayembe PK, et al. Food insecurity is associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the Democratic Republic of Congo: A cross-sectional study. PLoS One 2014; 9: e85327.
 
3.
Hong SY, Fanelli TJ, Jonas A, et al. Household food insecurity associated with antiretroviral therapy adherence among HIV-infected patients in Windhoek, Namibia. J Acquir Immune Defic Syndr 2014; 67: e115-122.
 
4.
Masa R, Chowa G, Nyirenda V. Prevalence and predictors of food insecurity among people living with HIV enrolled in antiretroviral therapy and livelihood programs in two rural Zambian hospitals. Ecol Food Nutr 2017; 56: 256-276.
 
5.
Mamlin J, Kimaiyo S, Lewis S, et al. Integrating nutrition support for food-insecure patients and their dependents into an HIV care and treatment program in western Kenya. Am J Public Health 2009; 99: 215-221.
 
6.
Tsai AC, Bangsberg DR, Emenyonu N, et al. The social context of food insecurity among persons living with HIV/AIDS in rural Uganda. Soc Sci Med 2011; 73: 1717-1724.
 
7.
Singer AW, Weiser SD, McCoy SI. Does food insecurity undermine adherence to antiretroviral therapy? A systematic review. AIDS Behav 2015; 19: 1510-1526.
 
8.
Weiser SD, Tsai AC, Gupta R, et al. Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting. AIDS 2012; 26: 67-75.
 
9.
Koethe JR, Blevins M, Bosire C, et al. Self-reported dietary intake and appetite predict early treatment outcome among low-BMI adults initiating HIV treatment in sub-Saharan Africa. Public Health Nutr 2013; 16: 549-558.
 
10.
Rawat R, McCoy SI, Kadiyala S. Poor diet quality is associated with low CD4 count and anemia and predicts mortality among anti-retroviral therapy-naive HIV-positive adults in Uganda. J Acquir Immune Defic Syndr 2013; 62: 246-253.
 
11.
de Pee S, Semba RD. Role of nutrition in HIV infection: Review of evidence for more effective programming in resource-limited settings. Food Nutr Bull 2010; 31: S313-S344.
 
12.
Audain KA, Zotor FB, Amuna P, et al. Food supplementation among HIV-infected adults in sub-Saharan Africa: Impact on treatment adherence and weight gain. Proc Nutr Soc 2015; 74: 517-525.
 
13.
de Pee S, Grede N, Mehra D, et al. The enabling effect of food assistance in improving adherence and/or treatment completion for antiretroviral therapy and tuberculosis treatment: A literature review. AIDS Behav 2014; 18 (Suppl 5): S531-S541.
 
14.
Tirivayi N, Groot W. Health and welfare effects of integrating AIDS treatment with food assistance in resource constrained settings: A systematic review of theory and evidence. Soc Sci Med 2011; 73: 685-692.
 
15.
Aberman NL, Rawat R, Drimie S, et al. Food security and nutrition interventions in response to the AIDS epidemic: Assessing global action and evidence. AIDS Behav 2014; 18 (Suppl 5): S554-S565.
 
16.
Yager JE, Kadiyala S, Weiser SD. HIV/AIDS, food supplementation and livelihood programs in Uganda: A way forward? PLoS One 2011; 6: e26117.
 
17.
Cantrell RA, Sinkala M, Megazinni K, et al. A pilot study of food supplementation to improve adherence to antiretroviral therapy among food-insecure adults in Lusaka, Zambia. J Acquir Immune Defic Syndr 2008; 49: 190-195.
 
18.
Tirivayi N, Koethe JR, Groot W. Clinic-based food assistance is associated with increased medication adherence among HIV-infected adults on long-term antiretroviral therapy in Zambia. J AIDS Clin Res 2012; 3: 171.
 
19.
Kebede MA, Haidar J. Factors influencing adherence to the food by prescription program among adult HIV positive patients in Addis Ababa, Ethiopia: A facility-based, cross-sectional study. Infect Dis Poverty 2014; 3: 20.
 
20.
Ndirangu M, Sztam K, Sheriff M, et al. Perceptions of food-insecure HIV-positive adults participating in a food supplementation program in central Kenya. J Health Care Poor Underserved 2014; 25: 1763-1783.
 
21.
Bahwere P, Sadler K, Collins S. Acceptability and effectiveness of chickpea sesame-based ready-to-use therapeutic food in malnourished HIV-positive adults. Patient Prefer Adherence 2009; 3: 67-75.
 
22.
Posse M, Baltussen R. HIV/AIDS patient satisfaction with a food assistance programme in Sofala Province, Mozambique. Afr J AIDS Res 2013; 12: 203-210.
 
23.
Rothman J, Kayigamba F, Hills V, et al. The impact of a community-based intervention including a monthly food ration on food insecurity among HIV-positive adults during the first year of antiretroviral therapy. AIDS Behav 2018; 22: 154-163.
 
24.
Rawat R, Faust E, Maluccio JA, et al. The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda. J Acquir Immune Defic Syndr 2014; 66: e15-22.
 
25.
Palar K, Martin A, Oropeza Camacho ML, et al. Livelihood experiences and adherence to HIV antiretroviral therapy among participants in a food assistance pilot in Bolivia: A qualitative study. PLoS One 2013; 8: e61935.
 
26.
Ivers LC, Teng JE, Jerome JG, et al. A randomized trial of ready-to-use supplementary food versus corn-soy blend plus as food rations for HIV-infected adults on antiretroviral therapy in rural Haiti. Clin Infect Dis 2014; 58: 1176-1184.
 
27.
Palar K, Derose KP, Linnemayr S, et al. Impact of food support on food security and body weight among HIV antiretroviral therapy recipients in Honduras: A pilot intervention trial. AIDS Care 2015; 27: 409-415.
 
28.
Brown M, Nga TT, Hoang MA, et al. Acceptability of two ready-to-use therapeutic foods by HIV-positive patients in Vietnam. Food Nutr Bull 2015; 36: 102-110.
 
29.
Holmes K, Winskell K, Hennink M, et al. Microfinance and HIV mitigation among people living with HIV in the era of anti-retroviral therapy: Emerging lessons from Cote d’Ivoire. Glob Public Health 2011; 6: 447-461.
 
30.
Bezabih T, Weiser SD, Menbere MS, et al. Comparison of treatment adherence outcome among PLHIV enrolled in economic strengthening program with community control. AIDS Care 2018; 30: 369-377.
 
31.
Weiser SD, Bukusi EA, Steinfeld RL, et al. Shamba maisha: Randomized controlled trial of an agricultural and finance intervention to improve HIV health outcomes. AIDS 2015; 29: 1889-1894.
 
32.
Datta D, Njuguna J. Microcredit for people affected by HIV and AIDS: Insights from Kenya. SAHARA J 2008; 5: 94-102.
 
33.
van der Land H, Fowler B, Brand M, et al. Assessment of livelihood strategies to promote food security among people living with HIV/AIDS in Namibia. Livelihood and Food Security Technical Assistance, FHI 360, Washington 2010.
 
34.
Wagner G, Rana Y, Linnemayr S, et al. A qualitative exploration of the economic and social effects of microcredit among people living with HIV/AIDS in Uganda. AIDS Res Treat 2012; 2012: 318957.
 
35.
Masa R, Chowa G. A multilevel conceptual framework to understand the role of food insecurity on antiretroviral therapy adherence in low-resource settings: from theory to practice. Soc Work Public Health 2017; 32: 324-338.
 
36.
Byron E, Gillespie S, Nangami M. Integrating nutrition security with treatment of people living with HIV: Lessons from Kenya. Food Nutr Bull 2008; 29: 87-97.
 
37.
Dibari F, Bahwere P, Le Gall I, et al. A qualitative investigation of adherence to nutritional therapy in malnourished adult AIDS patients in Kenya. Public Health Nutr 2012; 15: 316-323.
 
38.
Rodas-Moya S, Kodish S, Manary M, et al. Preferences for food and nutritional supplements among adult people living with HIV in Malawi. Public Health Nutr 2016; 19: 693-702.
 
39.
Kadiyala S, Rawat R, Roopnaraine T, et al. Applying a programme theory framework to improve livelihood interventions integrated with HIV care and treatment programmes. J Dev Effect 2009; 1: 470-491.
 
40.
Tsai AC, Hatcher AM, Bukusi EA, et al. A livelihood intervention to reduce the stigma of HIV in rural Kenya: longitudinal qualitative study. AIDS Behav 2017; 21: 248-260.
 
41.
Holmes K, Winskell K. Understanding and mitigating HIV-related resource-based stigma in the era of antiretroviral therapy. AIDS Care 2013; 25: 1349-1355.
 
42.
Ndekha M, van Oosterhout JJ, Saloojee H, et al. Nutritional status of Malawian adults on antiretroviral therapy 1 year after supplementary feeding in the first 3 months of therapy. Trop Med Int Health 2009; 14: 1059-1063.
 
43.
Banerjee A, Duflo E, Goldberg N, et al. A multifaceted program causes lasting progress for the very poor: evidence from six countries. Science 2015; 348: 1260799.
 
44.
Hanlon DH, Barrientos A. Just give money to the poor: the development revolution from the Global South. Kumarian Press, Sterling 2010.
 
45.
McCoy SI, Njau PF, Fahey C, et al. Cash vs. food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania. AIDS 2017; 31: 815-825.
 
eISSN:1732-2707
ISSN:1730-1270
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