Skip to main content

Advertisement

SpringerLink
Log in

Food Insecurity is Longitudinally Associated with Depressive Symptoms Among Homeless and Marginally-Housed Individuals Living with HIV

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Depression and food insecurity are prevalent among people with HIV (PLHIV) and contribute to poor HIV outcomes. Longitudinal data can help clarify the effect of food insecurity on depression among PLHIV in the United States. We assessed the longitudinal association of food insecurity with symptoms of depression using validated measures among participants living with HIV from the Research on Access to Care in the Homeless cohort in San Francisco. We followed 346 participants for a median of 28 months. Over half of participants (55.0 %) were food insecure and 35.8 % had symptoms of depression. In adjusted models, severe food insecurity in the previous period was associated with increased depressive symptom severity (b = 1.22; p < 0.001). The association remained statistically significant in models including participant fixed effects. Severe food insecurity was also longitudinally associated with a binary variable indicating probable depression. Efforts to increase access to and participation in food security safety net programs for PLHIV could improve depression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Orlando M, Burnam MA, Beckman R, Morton SC, London AS, Bing EG, et al. Re-estimating the prevalence of psychiatric disorders in a nationally representative sample of persons receiving care for HIV: results from the HIV cost and services utilization study. Int J Methods Psychiatr Res. 2002;11(2):75–82.

    Article  PubMed  Google Scholar 

  2. Bing EG, Burnam MA, Longshore D, Fleishman JA, Sherbourne CD, London AS, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.

    Article  CAS  PubMed  Google Scholar 

  3. Rabkin JG. HIV and depression: 2008 review and update. Curr HIV/AIDS Rep. 2008;5(4):163–71.

    Article  PubMed  Google Scholar 

  4. Leserman J. Role of depression, stress, and trauma in HIV disease progression. Psychosom Med. 2008;70(5):539–45.

    Article  PubMed  Google Scholar 

  5. Carrico AW, Bangsberg DR, Weiser SD, Chartier M, Dilworth SE, Riley ED. Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons. AIDS. 2011;25(8):1113–8.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7.

    PubMed  Google Scholar 

  7. Cook JA, Grey D, Burke J, Cohen MH, Gurtman AC, Richardson JL, et al. Depressive symptoms and AIDS-related mortality among a multisite cohort of HIV-positive women. Am J Public Health. 2004;94(7):1133–40.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Chartier M, Carrico AW, Weiser SD, Kushel MB, Riley ED. Specific psychiatric correlates of acute care utilization among unstably housed HIV-positive adults. AIDS Care. 2012;24(12):1514–8.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Tsai AC, Weiser SD, Petersen ML, Ragland K, Kushel MB, Bangsberg DR. A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV. Arch Gen Psychiatry. 2010;67(12):1282–90.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Yun LWH, Maravi M, Kobayashi JS, Barton PL, Davidson AJ. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J Acquir Immune Defic Syndr. 2005;38(4):432–8.

    Article  CAS  PubMed  Google Scholar 

  11. World Health Organization. Priority interventions: HIV/AIDS prevention, treatment and care in the health sector. Geneva: World Health Organization, HIV/AIDS Department; 2010.

    Google Scholar 

  12. Life Sciences Research Office (LSRO), Anderson Se. Core indicators of nutritional state for difficult-to-sample populations. J Nutr. 1990;120(Suppl 11):1559–600.

    Google Scholar 

  13. Kalichman S, Cherry C, Amaral C, White D, Kalichman M, Pope H, et al. Health and treatment implications of food insufficiency among people living with HIV/AIDS, Atlanta, Georgia. J Urban Health. 2010;87(4):1–11.

    Article  Google Scholar 

  14. Normen L, Chan K, Braitstein P, Anema A, Bondy G, Montaner JS, et al. Food insecurity and hunger are prevalent among HIV-positive individuals in British Columbia. Canada. J Nutr. 2005;135(4):820–5.

    CAS  PubMed  Google Scholar 

  15. Weiser S, Tsai AC, Gupta R, Frongillo EA, Kawuma A, Senkugu J, et al. Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in rural Uganda. AIDS. 2012;26(1):67–75.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Weiser SD, Yuan C, Guzman D, Frongillo EA, Riley ED, Bangsberg DR, et al. Food insecurity and HIV clinical outcomes in a longitudinal study of homeless and marginally housed HIV-infected individuals in San Francisco. AIDS. 2013;27(18):2953–8.

    Article  PubMed  Google Scholar 

  17. McMahon JH, Wanke CA, Elliott JH, Skinner S, Tang AM. Repeated assessments of food security predict CD4 change in the setting of antiretroviral therapy. JAIDS. 2011;58(1):60–3.

    PubMed Central  PubMed  Google Scholar 

  18. Weiser S, Frongillo EA, Ragland K, Hogg RS, Riley ED, Bangsberg DR. Food insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. J Gen Intern Med. 2009;24(1):14–20.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Wang EA, McGinnis KA, Fiellin DA, Goulet JL, Bryant K, Gibert CL, et al. Food insecurity is associated with poor virologic response among HIV-infected patients receiving antiretroviral medications. J Gen Intern Med. 2011;26(9):1012–8.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Weiser S, Fernandes K, Brandson E, Lima V, Anema A, Bangsberg D, et al. The association between food insecurity and mortality among HIV-infected individuals on HAART. J Acquir Immune Defic Syndr. 2009;52(3):342–9.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Wu Z, Schimmele CM. Food insufficiency and depression. Sociol Perspect. 2005;48(4):481–504.

    Article  Google Scholar 

  22. Vozoris NT, Tarasuk VS. Household food insufficiency is associated with poorer health. J Nutr. 2003;133(1):120–6.

    CAS  PubMed  Google Scholar 

  23. Alaimo K, Olson CM, Frongillo EA. Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents. J Nutr. 2002;132(4):719–25.

    CAS  PubMed  Google Scholar 

  24. Muldoon KA, Duff PK, Fielden S, Anema A. Food insufficiency is associated with psychiatric morbidity in a nationally representative study of mental illness among food insecure Canadians. Soc Psychiatry Psychiatr Epidemiol. 2013;48(5):795–803.

    Article  PubMed  Google Scholar 

  25. Heflin CM, Siefert K, Williams DR. Food insufficiency and women’s mental health: findings from a 3-year panel of welfare recipients. Soc Sci Med. 2005;61(9):1971–82.

    Article  PubMed  Google Scholar 

  26. Siefert K, Heflin CM, Corcoran ME, Williams DR. Food insufficiency and physical and mental health in a longitudinal survey of welfare recipients. J Health Soc Behav. 2004;45(2):171–86.

    Article  PubMed  Google Scholar 

  27. Siefert K, Heflin CM, Corcoran ME, Williams DR. Food insufficiency and the physical and mental health of low-income women. Women Health. 2001;32(1–2):159–77.

    Article  CAS  PubMed  Google Scholar 

  28. Weiser S, Young S, Cohen C, Kushel M, Tsai A, Tien P, et al. Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. Am J Clin Nutr. 2011;94(suppl):1729S–39S.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  29. Belle Doucet D. Poverty, inequality, and discrimination as sources of depression among US women. Psychol Women Q. 2003;27(2):101–13.

    Article  Google Scholar 

  30. Rose D. Economic determinants and dietary consequences of food insecurity in the United States. J Nutr. 1999;129(2S Suppl):517S–20S.

    CAS  PubMed  Google Scholar 

  31. Dixon LB, Winkleby MA, Radimer KL. Dietary intakes and serum nutrients differ between adults from food-insufficient and food-sufficient families: third national health and nutrition examination survey, 1988–1994. J Nutr. 2001;131(4):1232–46.

    CAS  PubMed  Google Scholar 

  32. Kirkpatrick SI, Tarasuk V. Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. J Nutr. 2008;138(3):604–12.

    CAS  PubMed  Google Scholar 

  33. Bodnar LM, Wisner KL. Nutrition and depression: implications for improving mental health among childbearing-aged women. Biol Psychiatry. 2005;58(9):679–85.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Rechenberg K, Humphries D. Nutritional interventions in depression and perinatal depression. Yale J Biol Med. 2013;86(2):127–37.

    CAS  PubMed Central  PubMed  Google Scholar 

  35. Vogenthaler NS, Hadley C, Rodriguez AE, Valverde EE, del Rio C, Metsch LR. Depressive symptoms and food insufficiency among HIV-infected crack users in Atlanta and Miami. AIDS Behav. 2011;15(7):1520–6.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Anema A, Weiser S, Fernandes K, Ding E, Brandson E, Palmer A, et al. High prevalence of food insecurity among HIV-infected individuals receiving HAART in a resource-rich setting. AIDS Care. 2011;23(2):221–30.

    Article  CAS  PubMed  Google Scholar 

  37. Judd LL, Akiskal HS, Maser JD, Zeller PJ, Endicott J, Coryell W, et al. A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry. 1998;55(8):694–700.

    Article  CAS  PubMed  Google Scholar 

  38. Robertson MJ, Clark RA, Charlebois ED, Tulsky J, Long HL, Bangsberg DR, et al. HIV seroprevalence among homeless and marginally housed adults in San Francisco. Am J Pub Health. 2004;94(7):1207–17.

    Article  Google Scholar 

  39. Zolopa AR, Hahn JA, Gorter R, Miranda J, Wlodarczyk D, Peterson J, et al. HIV and tuberculosis infection in San Francisco’s homeless adults. Prevalence and risk factors in a representative sample. JAMA. 1994;272(6):455–61.

    Article  CAS  PubMed  Google Scholar 

  40. Beck A, Steer R, Brown G. Manual for beck depression inventory II (BDI-II). San Antonio: Psychology Corporation; 1996.

    Google Scholar 

  41. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edition: DSM-IV-TR. Washington: American Psychiatric Publishing, Inc.; 1994.

    Google Scholar 

  42. American Psychiatric Association. Highlights of changes from the DSM-IV-TR to DSM-V. American Psychiatric Association; 2013. http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf. Accessed 30 Aug 2014.

  43. Thombs BD, Ziegelstein RC, Pilote L, Dozois DJA, Beck AT, Dobson KS, et al. Somatic symptom overlap in Beck Depression Inventory–II scores following myocardial infarction. Br J Psychiatry. 2010;197(1):61–6.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Kalichman SC, Rompa D, Cage M. Distinguishing between overlapping somatic symptoms of depression and HIV disease in people living with HIV-AIDS. J Nerv Ment Dis. 2000;188(10):662–70.

    Article  CAS  PubMed  Google Scholar 

  45. Kalichman SC, Sikkema KJ, Somlai A. Assessing persons with human immunodeficiency virus (HIV) infection using the Beck Depression Inventory: disease processes and other potential confounds. J Pers Assess. 1995;64(1):86–100.

    Article  CAS  PubMed  Google Scholar 

  46. Ward LC. Comparison of factor structure models for the Beck Depression Inventory–II. Psychol Assess. 2006;18(1):81.

    Article  PubMed  Google Scholar 

  47. Swindale A, Bilinsky P. Development of a universally applicable household food insecurity measurement tool: process, current status, and outstanding issues. J Nutr. 2006;136(5):1449S–52S.

    CAS  PubMed  Google Scholar 

  48. Frongillo EA, Nanama S. Development and validation of an experience-based measure of household food insecurity within and across Seasons in Northern Burkina Faso. J Nutr. 2006;136(5):1409S–19S.

    CAS  PubMed  Google Scholar 

  49. 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 Behav. 2009;13(5):841–8.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Coates J, Swindale A, Bilinsky P. Household food insecurity access scale (HFIAS) for measurement of food access: indicator guide. Washington: Food and Nutrition Technical Assistance Project, Academy for Educational Development; 2007.

    Google Scholar 

  51. Enoch M, Goldman D. Problem drinking and alcoholism: diagnosis and treatment. Am Fam Physician. 2002;65(3):441–9.

    PubMed  Google Scholar 

  52. Friedmann PD, Saitz R, Gogineni A, Zhang JX, Stein MD. Validation of the screening strategy in the NIAAA “physicians’ guide to helping patients with alcohol problems”. J Stud Alcohol Drugs. 2001;62(2):234.

    Article  CAS  Google Scholar 

  53. Tsai AC, Bangsberg DR, Frongillo EA, Hunt PW, Muzoora C, Martin JN, et al. Food insecurity, depression and the modifying role of social support among people living with HIV/AIDS in rural Uganda. Soc Sci Med. 2012;74(12):2012–9.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Fielden SJ, Anema A, Fergusson P, Muldoon K, Grede N, de Pee S. Measuring food and nutrition security: tools and considerations for use among people living with HIV. AIDS Behav. 2014;18(Suppl 5):490–504.

    Article  Google Scholar 

  55. Hamelin A-M, Beaudry M, Habicht J-P. Characterization of household food insecurity in Quebec: food and feelings. Soc Sci Med. 2002;54(1):119–32.

    Article  PubMed  Google Scholar 

  56. Nanama S, Frongillo EA. Altered social cohesion and adverse psychological experiences with chronic food insecurity in the non-market economy and complex households of Burkina Faso. Soc Sci Med. 2012;74(3):444–51.

    Article  PubMed  Google Scholar 

  57. Larson NI, Story MT. Food insecurity and weight status among US children and families: a review of the literature. Am J Prev Med. 2011;40(2):166–73.

    Article  PubMed  Google Scholar 

  58. Anema A, Fielden SJ, Castleman T, Grede N, Heap A, Bloem M. Food security in the context of HIV: towards harmonized definitions and indicators. AIDS Behav. 2014;18(Suppl 5):476–89.

    Article  Google Scholar 

  59. Kim K, Frongillo EA. Participation in food assistance programs modifies the relation of food insecurity with weight and depression in elders. J Nutr. 2007;137(4):1005–10.

    CAS  PubMed  Google Scholar 

  60. Wang EA, Zhu GA, Evans L, Carroll-Scott A, Desai R, Fiellin LE. A pIlot study examInIng food insecurity and HIV risk behaviors among individuals recently released from prison. AIDS Educ Prev. 2013;25(2):112–23.

    Article  PubMed Central  PubMed  Google Scholar 

  61. Centers for Medicaid and Medicare Services. National Coverage Determination (NCD) for Medical Nutrition Therapy (180.1). Washington, DC: Centers for Medicaid and Medicare Services; 2002. http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=252&ncdver=1&NCAId=53&NcaName=Medical+Nutrition+Therapy+Benefit+for+Diabetes+%2526+ESRD&IsPopup=y&bc=AAAAAAAAIAAA&. Accessed 31 Aug 2013.

  62. Rosenthal TC. The medical home: growing evidence to support a new approach to primary care. J Am Board Fam Med. 2008;21(5):427–40.

    Article  PubMed  Google Scholar 

  63. Hoisington A, Braverman M, Hargunani D, Adams E, Alto C. Health care providers’ attention to food insecurity in households with children. Prev Med. 2012;55(3):219–22.

    Article  CAS  PubMed  Google Scholar 

  64. Burkhardt MC, Beck AF, Conway PH, Kahn RS, Klein MD. Enhancing accurate identification of food insecurity using quality-improvement techniques. Pediatrics. 2012;129(2):e504–10.

    Article  PubMed  Google Scholar 

  65. Garg A, Butz AM, Dworkin PH, Lewis RA, Serwint JR. Screening for basic social needs at a medical home for low-income children. Clin Pediatr (Phila). 2009;48(1):32–6.

    Article  PubMed  Google Scholar 

  66. Waitzkin H, Getrich C, Heying S, Rodríguez L, Parmar A, Willging C, et al. Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression. J Community Health. 2011;36(2):316–31.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Shumway M, Sentell T, Unick G, Bamberg W. Cognitive complexity of self-administered depression measures. J Affect Disord. 2004;83(2):191–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by NIMH RO154907 (PI: Dr Bangsberg) CHRP ID08-SF-054; UCSF Academic Senate; Hurlbut-Johnson funds from AIDS Research Institute award, UCSF, # 557858-8-148. The authors acknowledge the following additional sources of salary support: AHRQ T32HS00046 (Dr. Palar), R01 MH095683 and the Burke Family Foundation (Dr. Weiser), and NIMH K24 87227 (Dr. Bangsberg).

Author information

Authors and Affiliations

  1. Division of HIV/AIDS, San Francisco General Hospital, University of California San Francisco (UCSF), 995 Potrero Avenue, Building 80, Ward 84, Campus Box 0874, San Francisco, CA, 94110, USA

    Kartika Palar, Elise D. Riley & Sheri D. Weiser

  2. Division of General Internal Medicine, San Francisco General Hospital, UCSF, San Francisco, CA, USA

    Margot Kushel

  3. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Edward A. Frongillo

  4. United Nations World Food Programme, Rome, Italy

    Nils Grede

  5. Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard, Harvard Medical School, Boston, MA, USA

    David Bangsberg

  6. Harvard School of Public Health, Boston, MA, USA

    David Bangsberg

  7. Center for AIDS Prevention Studies, UCSF, San Francisco, CA, USA

    Sheri D. Weiser

Authors
  1. Kartika Palar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margot Kushel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edward A. Frongillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elise D. Riley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nils Grede
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Bangsberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sheri D. Weiser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kartika Palar.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Palar, K., Kushel, M., Frongillo, E.A. et al. Food Insecurity is Longitudinally Associated with Depressive Symptoms Among Homeless and Marginally-Housed Individuals Living with HIV. AIDS Behav 19, 1527–1534 (2015). https://doi.org/10.1007/s10461-014-0922-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-014-0922-9

Keywords

Search

Navigation