AIDS and Behavior

, Volume 17, Issue 5, pp 1683–1687 | Cite as

Food Insecurity, CD4 Counts, and Incomplete Viral Suppression Among HIV+ Patients from Texas Children’s Hospital: A Pilot Study

  • Jason A. Mendoza
  • Mary E. Paul
  • Heidi Schwarzwald
  • Yan Liu
  • Richard Martinez
  • Theresa A. Nicklas
  • Tom Baranowski
Brief Report

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

ARV

Antiretroviral

CD

Cluster of differentiation

HIV

Human immunodeficiency virus

PCR

Polymerase chain reaction

TCH

Texas Children’s Hospital

US(A)

United States (of America)

References

  1. 1.
    Centers for Disease Control and Prevention. HIV Surveillance Report, 2010. Atlanta: U.S. Department of Health and Human Services; 2012.Google Scholar
  2. 2.
    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.Google Scholar
  3. 3.
    Kursmark M, Weitzman M. Recent findings concerning childhood food insecurity. Curr Opin Clin Nutr Metab Care. 2009;12(3):310–6.PubMedCrossRefGoogle Scholar
  4. 4.
    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.PubMedCrossRefGoogle Scholar
  5. 5.
    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.PubMedCrossRefGoogle Scholar
  6. 6.
    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.PubMedCrossRefGoogle Scholar
  7. 7.
    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.PubMedCrossRefGoogle Scholar
  8. 8.
    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.PubMedCrossRefGoogle Scholar
  9. 9.
    Feeding America. Map the Meal Gap: Child Food Insecurity 2012. Chicago: Feeding America; 2012.Google Scholar
  10. 10.
    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.PubMedCrossRefGoogle Scholar
  11. 11.
    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.Google Scholar
  12. 12.
    Frongillo EA. Validation of measures of food insecurity and hunger. J. Nutr. 1999;129(2):506S–9S.PubMedGoogle Scholar
  13. 13.
    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.Google Scholar
  14. 14.
    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.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jason A. Mendoza
    • 1
    • 2
    • 3
  • Mary E. Paul
    • 2
    • 4
  • Heidi Schwarzwald
    • 5
  • Yan Liu
    • 1
  • Richard Martinez
    • 1
  • Theresa A. Nicklas
    • 1
  • Tom Baranowski
    • 1
    • 3
  1. 1.Department of Pediatrics, Children’s Nutrition Research CenterBaylor College of MedicineHoustonUSA
  2. 2.Baylor-UTHouston Center for AIDS ResearchBaylor College of MedicineHoustonUSA
  3. 3.Dan L Duncan Cancer CenterBaylor College of MedicineHoustonUSA
  4. 4.Department of Pediatrics, Section of Retrovirology and Global HealthBaylor College of MedicineHoustonUSA
  5. 5.Department of Pediatrics, Section of Community PediatricsBaylor College of MedicineHoustonUSA

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