AIDS and Behavior

, Volume 21, Issue 12, pp 3464–3472 | Cite as

Impact of Food Insecurity on Depressive Symptoms Among HIV–HCV Co-infected People

  • Wusiman Aibibula
  • Joseph Cox
  • Anne-Marie Hamelin
  • Erica E. M. Moodie
  • Ashley I. Naimi
  • Taylor McLinden
  • Marina B. Klein
  • Paul Brassard
  • Canadian Co-infection Cohort Investigators
Original Paper


Food insecurity (FI) is associated with depressive symptoms among HIV mono-infected people. Our objective was to examine to what extent this association holds among HIV–hepatitis C virus (HCV) co-infected people. We used data from a prospective cohort study of HIV–HCV co-infected people in Canada. FI was measured using the ten-item adult scale of Health Canada’s Household Food Security Survey Module and was classified into three categories: food secure, moderate FI, and severe FI. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10) and was classified into absence or presence of depressive symptoms. FI, depressive symptoms, and other covariates were updated every 6 months. The association between FI and depressive symptoms was assessed using a stabilized inverse probability weighted marginal structural model. The study sample included 725 HIV–HCV co-infected people with 1973 person-visits over 3 years of follow up. At baseline, 23% of participants experienced moderate food insecurity, 34% experienced severe food insecurity and 52% had depressive symptoms. People experiencing moderate FI had 1.63 times (95% CI 1.44–1.86) the risk of having depressive symptoms and people experiencing severe FI had 2.01 times (95% CI 1.79–2.25) the risk of having depressive symptoms compared to people who were food secure. FI is a risk factor for developing depressive symptoms among HIV–HCV co-infected people. Food supplementation, psychosocial support and counseling may improve patient health outcomes.


HIV–HCV co-infection Food insecurity Depression Marginal structural model 


Authors contribution

Each author has participated sufficiently in the work to believe in its overall validity and to take public responsibility for appropriate portions of its content.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.

Ethical Statement

The Food Security Sub-Study and the Canadian Co-infection Cohort were approved by the research ethics boards of the participating institutions, and the secondary use of data for this analysis was approved by the McGill University Health Centre Research Ethics Board.

Supplementary material

10461_2017_1942_MOESM1_ESM.docx (42 kb)
Supplementary material 1 (DOCX 42 kb)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Wusiman Aibibula
    • 1
  • Joseph Cox
    • 1
    • 2
  • Anne-Marie Hamelin
    • 1
  • Erica E. M. Moodie
    • 1
  • Ashley I. Naimi
    • 3
  • Taylor McLinden
    • 1
  • Marina B. Klein
    • 1
    • 4
  • Paul Brassard
    • 1
    • 4
    • 5
    • 6
  • Canadian Co-infection Cohort Investigators
  1. 1.Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontrealCanada
  2. 2.Public Health DepartmentCIUSSS du Centre-Est-de-l ‘Ile-de-MontréalMontréalCanada
  3. 3.Department of EpidemiologyUniversity of PittsburghPittsburghUSA
  4. 4.Department of MedicineMcGill UniversityMontrealCanada
  5. 5.Division of Clinical EpidemiologyMcGill University Health CentreMontrealCanada
  6. 6.Centre for Clinical EpidemiologyJewish General HospitalMontrealCanada

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