Food insecurity at HIV diagnosis associated with subsequent viremia amongst adults living with HIV in an urban township of South Africa

Abstract

We assessed the impact of food insecurity on antiretroviral adherence, retention in care, hospitalization, mortality, and HIV viremia in an urban township of Kwazulu-Natal, South Africa. At the time of HIV testing, food security status was assessed using the Household Food Insecurity Access Scale (HFIAS), and people living with HIV were followed for at least twelve months. Among 2,383 HIV-positive participants, 253 (10.6%) experienced food insecurity. Food insecurity was associated with higher adjusted odds of having HIV viremia (>1,000 copies/mL) at 12 months after HIV testing (aPOR 1.2, P=0.001). At HIV testing, persons with WHO Stage 2 (aPOR 1.5, P=0.016) or Stage 3 (aPOR 1.7, P=0.001) disease were more likely to have experienced food insecurity.