Food Insecurity, CD4 Counts, and Incomplete Viral Suppression Among HIV+ Patients from Texas Children’s Hospital: A Pilot Study
First Online: 02 February 2013 DOI:
Cite this article as: Mendoza, J.A., Paul, M.E., Schwarzwald, H. et al. AIDS Behav (2013) 17: 1683. doi:10.1007/s10461-013-0419-y Abstract
Determine the relationship between food insecurity and CD4 counts and viral suppression among pediatric HIV-positive patients. Food insecurity was assessed by validated survey. CD4 counts and viral load were abstracted from patients’ charts. We used linear regression for the dependent variable of the natural log of CD4 counts and logistic regression for viral suppression, with backward deletion of covariates with
p > 0.1. Food insecurity (β = −0.23, 95 % CI [−0.40, −0.01]) was associated with lower CD4 counts and higher odds of incomplete viral suppression (OR = 4.07, 95 % CI [1.02, 13.92]). Food insecurity may adversely impact pediatric HIV outcomes. Keywords Pediatric HIV Food security CD4 count Viral load Abbreviations ANOVA
Analysis of variance
Cluster of differentiation
Human immunodeficiency virus
Polymerase chain reaction
Texas Children’s Hospital
United States (of America)
Centers for Disease Control and Prevention. HIV Surveillance Report, 2010. Atlanta: U.S. Department of Health and Human Services; 2012.
Coleman-Jensen A, Nord M, Andrews M, Carlson S. Household Food Security in the United States in 2010. Washington, DC: ERR-125, US Department of Agriculture, Economic Research Service; 2011.
Kursmark M, Weitzman M. Recent findings concerning childhood food insecurity. Curr Opin Clin Nutr Metab Care. 2009;12(3):310–6.
Kalichman S, Cherry C, Amaral C, et al. Health and treatment implications of food insufficiency among people living with HIV/AIDS, Atlanta, Georgia. J Urban Health. 2010;87(4):631–41.
Weiser SD, Bangsberg DR, Kegeles S, Ragland K, Kushel MB, Frongillo EA. Food insecurity among homeless and marginally housed individuals living with HIV/AIDS in San Francisco. AIDS Behav. 2009;13(5):841–8.
Weiser SD, Fernandes KA, Brandson EK, et al. The association between food insecurity and mortality among HIV-infected individuals on HAART. JAIDS. 2009;52(3):342–9.
McMahon JH, Wanke CA, Elliott JH, Skinner S, Tang AM. Repeated assessments of food security predict CD4 change in the setting of antiretroviral therapy. J Acquir Immune Defic Syndr. 2011;58(1):60–3.
Weiser SD, Young SL, Cohen CR, et al. Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. Am J Clin Nutr. 2011;94(6):1729S–39S.
Feeding America. Map the Meal Gap: Child Food Insecurity 2012. Chicago: Feeding America; 2012.
Paintsil E, Ghebremichael M, Romano S, Andiman WA. Absolute CD4 + T-lymphocyte count as a surrogate marker of pediatric human immunodeficiency virus disease progression. Pediatr Infect Dis J. 2008;27(7):629–35.
Chandra A, Billioux VG, Copen CE, Sionean C. HIV risk-related behaviors in the United States household population aged 15–44 years: data from the national survey of family growth, 2002 and 2006–2010. Hyattsville: National Center for Health Statistics; 2012.
Frongillo EA. Validation of measures of food insecurity and hunger. J. Nutr. 1999;129(2):506S–9S.
Panel to Review the U.S. Department of Agriculture’s Measurement of Food Insecurity and Hunger. Food insecurity and hunger in the United States: an assessment of the measure. Washington, DC: The National Academies Press; 2006.
Ivers Louise C, Cullen Kimberly A, Freedberg Kenneth A, Block S, Coates J, Webb P. HIV/AIDS: HIV/AIDS, undernutrition, and food insecurity. Clin Infect Dis. 2009;49(7):1096–1102.
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