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Food Insufficiency is a Risk Factor for Suboptimal Antiretroviral Therapy Adherence among HIV-Infected Adults in Urban Peru

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Abstract

We examined the relationship between food insufficiency and antiretroviral therapy (ART) adherence. A cohort of HIV-infected adults in urban Peru was followed for a two-year period after ART initiation. ART adherence was measured using a 30-day self-report tool and classified as suboptimal if <95% adherence was reported. We conducted a repeated measures cohort analysis to examine whether food insufficiency was more common during months of suboptimal adherence relative to months with optimal adherence. 1,264 adherence interviews were conducted for 134 individuals. Participants who reported food insufficiency in the month prior to interview were more likely to experience suboptimal adherence than those who did not (odds ratio [O.R.]:2.4; 95% confidence interval [C.I.]:1.4, 4.1), even after adjusting for baseline social support score (O.R. per 5 point increase:0.91; C.I.:[0.85, 0.98]) and good baseline adherence self-efficacy (O.R.:0.25; C.I.:[0.09, 0.69]). Interventions that ensure food security for HIV-infected individuals may help sustain high levels of adherence.

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Acknowledgments

This project was supported by the Office for AIDS Research at the National Institutes for Health; the Eleanor and Miles Shore Fellowship at Harvard Medical School; David Rockefeller Center for Latin American Studies at Harvard University, and Partners In Health. M.F.F. received support from National Institute of Allergy and Infectious Diseases Pre-Doctoral Training Program in the Epidemiology of Infectious Diseases and Biodefense (T32 AI007535). We thank Dr. David Bangsberg for his comments on a previous version of this manuscript.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Molly F. Franke, Megan B. Murray & Sonia Hernández-Díaz

  2. Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA

    Megan B. Murray, Sidney Atwood, Adolfo Caldas, Jaime Bayona & Sonya S. Shin

  3. Socios En Salud Sucursal Peru, Lima, Peru

    Maribel Muñoz & Jaime Bayona

  4. Peruvian National HIV Program, Lima, Peru

    José Luís Sebastián

Authors
  1. Molly F. Franke
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Correspondence to Molly F. Franke.

Appendix

Appendix

See Table 3.

Table 3 Repeated measures analysis of the relationship between food insufficiency and <100% adherence to antiretroviral therapy (63 cases, 113 outcomes, 1,264 interview months)
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Franke, M.F., Murray, M.B., Muñoz, M. et al. Food Insufficiency is a Risk Factor for Suboptimal Antiretroviral Therapy Adherence among HIV-Infected Adults in Urban Peru. AIDS Behav 15, 1483–1489 (2011). https://doi.org/10.1007/s10461-010-9789-6

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