Food insecurity and HIV medication adherence among people living with HIV in rural South-Africa

Abstract

Treatment adherence is crucial for people living with HIV to prevent suppression of the immune system and drug resistance. However, adherence is not always optimal and is influenced by many factors. There are social, psychological and biological reasons for not adhering to a treatment regimen. Food insecurity may increase immune suppression and is associated with worse health behaviors. We conducted this research to assess whether food insecurity is related to poor treatment adherence among people living with HIV in rural South Africa. We found that in women food insecurity is related to poor treatment adherence, but this was not observed for men. This involved both moderate and severe food insecurity. Therefore, this gender inequality regarding food insecurity should be addressed. Women had lower income, more depressive symptoms, were more often unemployed, less likely to have a stable relationship and less likely to be on treatment. This lower socio-economic status compared to men indicates that women should be empowered in order to mitigate this difference. More research is needed to address these differentials in food security and ART adherence between men and women. Additionally, further qualitative research should focus on reasons for non-adhering to treatment.