Journal of Community Health

, Volume 42, Issue 5, pp 1062–1068 | Cite as

Investigating Responses to Food Insecurity Among HIV Positive People in Resource Rich Settings: A Systematic Review

  • F. H. McKayEmail author
  • K. Lippi
  • M. Dunn


Many of the 36.7 million people living with HIV are also assumed to be food insecure. The implications of food insecurity in people living with HIV are significant, with food insecurity associated with an increased likelihood of tobacco, alcohol, and illicit drug use, experiences of depression or depressive symptoms, poor adherence and delayed uptake of HIV medication, nutritional vulnerability leading to interference of medication, and the uptake of risky behaviours as a way to gain access to food resources. This review sought to present the current intervention research around the experiences of food insecurity in PLWHA in high resource countries to determine successful models to address the issue. Only five articles were identified in a systematic search, three reported on studies that were conducted in the USA and two in Canada. Two articles were cross sectional, one was a program evaluation, one ethnography, and one took a qualitative approach. This review highlights a lack of published research in the area of HIV and food insecurity in resource rich countries. The findings of this study suggest that there are currently no standard or best practice ways to provide food aid to PLWHA to reduce food security. The lack of published results means that while there may be good programs operating in the community, this information and knowledge is not being shared, resulting in a lack of consistency in approach, possible duplication, and the potential for wasted resources. Overall, this review suggests a need for more dedicated evaluation and longitudinal research.


HIV Food security Food insecurity Systematic review 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study does not require ethical approval as this is a systematic review of existing publications.


  1. 1.
    Anema, A., Fielden, S. J., Shurgold, S., Ding, E., Messina, J., Jones, J. E., et al. (2016). Association between food insecurity and procurement methods among people living with HIV in a high resource setting. PLoS ONE, 11, 1–20.CrossRefGoogle Scholar
  2. 2.
    Anema A, Vogenthaler N, Frongillo EA, Kadiyala S & Weiser SD 2009. Food insecurity and HIV/AIDS: Current knowledge, gaps, and research priorities. Current HIV/AIDS Reports, 6, 224–231.CrossRefPubMedGoogle Scholar
  3. 3.
    Anema, A., Weiser, S. D., Fernandes, K. A., Ding, E., Brandson, E. K., Palmer, A., et al. (2011). High prevalence of food insecurity among HIV-infected individuals receiving HAART in a resource-rich setting. AIDS Care, 23, 221–230.CrossRefPubMedGoogle Scholar
  4. 4.
    Au, J. T., Kayitenkore, K., Shutes, E., Karita, E., Peters, P. J., Tichacek, A., et al. (2006). Access to adequate nutrition is a major potential obstacle to antiretroviral adherence among HIV-infected individuals in Rwanda. Aids, 20, 2116–2118.CrossRefPubMedGoogle Scholar
  5. 5.
    Bazerghi, C., McKay, F. H., & Dunn, M. (2016). The role of food banks in addressing food insecurity: A systematic review. Journal of Community Health, 41, 732–740.CrossRefPubMedGoogle Scholar
  6. 6.
    Brunner, R. L., Larson, T. A., Scott, B. J., Navarro, S., Huba, G. J., & Melchior, L. A. (2001). Evaluation of the impact and acceptance of a nutrition program in an HIV community clinic. AIDS Patient Care and STDs, 15, 533–543.CrossRefPubMedGoogle Scholar
  7. 7.
    Cantrell, R. A., Sinkala, M., Megazinni, K., Lawson-Marriott, S., Washington, S., Chi, B. H., et al. (2008). A pilot study of food supplementation to improve adherence to antiretroviral therapy among food-insecure adults in Lusaka, Zambia. JAIDS: Journal of Acquired Immune Deficiency Syndromes, 49, 190–195.PubMedGoogle Scholar
  8. 8.
    Choi, S. K. Y., Fielden, S., Globerman, J., Koornstra, J. J. J., Hambly, K., Walker, G., et al. (2015). Food insufficiency, housing and health-related quality of life: Results from the positive spaces, healthy places study. AIDS Care, 27, 1183–1190.CrossRefPubMedGoogle Scholar
  9. 9.
    Daponte, B. O., & Bade, S. (2006). How the private food assistance network evolved: Interactions between public and private responses to hunger. Nonprofit and Voluntary Sector Quarterly, 35, 668–690.CrossRefGoogle Scholar
  10. 10.
    de Pee, S., Grede, N., Mehra, D., & Bloem, M. W. (2014). The enabling effect of food assistance in improving adherence and/or treatment completion for antiretroviral therapy and tuberculosis treatment: A literature review. AIDS and Behavior, 18, 531–541.CrossRefGoogle Scholar
  11. 11.
    Deeks, S. G., Lewin, S. R., & Havlir, D. V. (2013). The end of AIDS: HIV infection as a chronic disease. Lancet, 382, 1525–1533.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    FAO (2013). The state of food insecurity in the world 2013: The multiple dimensions of food security. Rome: Food and agriculture organization.Google Scholar
  13. 13.
    FAO (2016). The State of Food Insecurity in the World 2015 [Online]. Rome. Retrieved March 2, 2017, from
  14. 14.
    FareShare, SecondBite & Foodbank Victoria (2011). Community Food Programs in Victoria, A report on the food needed and the infrastructure required [Online]. Retrieved January 7, 2014, from
  15. 15.
    Foodbank Australia (2012). End Hunger Report 2013, Sydney.Google Scholar
  16. 16.
    Hatsu, I., Johnson, P., Baum, M., Huffman, F., Thomlison, B., & Campa, A. (2014). Association of Supplemental Nutrition Assistance Program (SNAP) with health related quality of life and disease state of HIV infected patients. AIDS and Behavior, 18, 2198–2206.CrossRefPubMedGoogle Scholar
  17. 17.
    Ivers, L. C., Chang, Y., Jerome, J. G., & Freedberg, K. A. (2010). Food assistance is associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: A prospective observational cohort study. AIDS Research and Therapy, 7, 33.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Ivers, L. C., Cullen, K. A., Freedberg, K. A., Block, S., Coates, J., & Webb, P. (2009). HIV/AIDS, undernutrition, and food insecurity. Clinical Infectious Diseases, 49, 1096–1102.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Kalichman, S., Hernandez, D., Cherry, C., Kalichman, M., Washington, C., & Grebler, T. (2014). Food insecurity and other poverty indicators among people living with HIV/AIDS: Effects on treatment and health outcomes. Journal of Community Health, 39, 1133–1139.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Mamlin, J., Kimaiyo, S., Lewis, S., Tadayo, H., Jerop, F., Gichunge, C., et al. (2009). Integrating nutrition support for food-insecure patients and their dependents into an HIV care and treatment program in Western Kenya. American Journal of Public Health, 99, 215–221.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    McKay, F. H., & Dunn, M. (2015). Food security among asylum seekers in Melbourne. Australian and New Zealand journal of public health, 39, 344–349.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    McKay, F. H., & McKenzie, H. (2017). Food aid provision in metropolitan Melbourne: A mixed methods study. Journal of Hunger & Environmental Nutrition, 12, 11–25.CrossRefGoogle Scholar
  23. 23.
    Miewald, C., Ibanez-Carrasco, F., & Turner, S. (2010). Negotiating the local food environment: The lived experience of food access for low-income people living with HIV/AIDS. Journal of Hunger & Environmental Nutrition, 5, 510–525.CrossRefGoogle Scholar
  24. 24.
    Miller, C. L., Bangsberg, D. R., Tuller, D. M., Senkungu, J., Kawuma, A., Frongillo, E. A., et al. (2011). Food insecurity and sexual risk in an HIV endemic community in Uganda. AIDS and Behavior, 15, 1512–1519.CrossRefPubMedGoogle Scholar
  25. 25.
    Musumari, P., Wouters, E., Kayembe, P., Mbikayi, S., Suguimoto, S., Techasrivichien, T., et al. (2016). Food insecurity is associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the Democratic Republic of Congo: A cross-sectional study. PLoS ONE, 9, e85327.CrossRefGoogle Scholar
  26. 26.
    Posse, M., & Baltussen, R. (2013). HIV/AIDS patient satisfaction with a food assistance programme in Sofala province, Mozambique. African Journal of AIDS Research (AJAR), 12, 203–210.CrossRefGoogle Scholar
  27. 27.
    Proof (2017). Food Insecurity in Canada [Online]. Toronto. Retrieved March 2, 2017, from
  28. 28.
    Rascoe, D., & Dalton, S. (1993). Hungry, homeless, and HIV: A study of homeless visitors to an outreach meal center for people with. AIDS. Journal of Nutrition Education, 25, 205–207.CrossRefGoogle Scholar
  29. 29.
    Rawat, R., Faust, E., Maluccio, J. A., & Kadiyala, S. (2014). The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes, 66, e15–e22.CrossRefPubMedGoogle Scholar
  30. 30.
    Robaina, K. A., & Martin, K. S. (2013). Food insecurity, poor diet quality, and obesity among food pantry participants in Hartford, CT. Journal of Nutrition Education and Behavior, 45, 159–164.CrossRefPubMedGoogle Scholar
  31. 31.
    Singer, A., Weiser, S., & McCoy, S. (2015). Does food insecurity undermine adherence to antiretroviral therapy? A systematic review. AIDS & Behavior, 19, 1510–1526.CrossRefGoogle Scholar
  32. 32.
    Slater, J., Qadar, Z., & Bewza, J. (2015). Review of food and nutrition services provided by community-based organizations serving people with HIV in Canada. Canadian Journal of Dietetic Practice and Research, 76, 97–99.CrossRefPubMedGoogle Scholar
  33. 33.
    Swaminathan, S., Padmapriyadarsini, C., Yoojin, L., Sukumar, B., Iliayas, S., Karthipriya, J., et al. (2010). Nutritional supplementation in HIV-infected individuals in South India: A prospective interventional study. Clinical Infectious Diseases, 1, 51–57.CrossRefGoogle Scholar
  34. 34.
    Taylor A & Loopstra R. 2016. Too Poor to Eat; Food insecurity in the UK [Online]. Retrieved March 2, 2017, from
  35. 35.
    UNAIDS (2017). HIV data and estimates [Online].
  36. 36.
    USDA (2016). Food Security Status of U.S. Households in 2015 [Online]. Retrieved March 2, 2017, from
  37. 37.
    Weiser, S. D., Bangsberg, D. R., Kegeles, S., Ragland, K., Kushel, M. B., & Frongillo, E. A. (2009). Food insecurity among homeless and marginally housed individuals living with HIV/AIDS in San Francisco. AIDS & Behavior, 13, 841–848.CrossRefGoogle Scholar
  38. 38.
    Weiser, S. D., Fernandes, K. A., Brandson, E. K., Lima, V. D., Anema, A., Bangsberg, D. R., et al. (2009). The association between food insecurity and mortality among HIV-infected individuals on HAART. JAIDS: Journal of Acquired Immune Deficiency Syndromes, 52, 342–349.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Weiser, S. D., Frongillo, E. A., Ragland, K., Hogg, R. S., Riley, E. D., & Bangsberg, D. R. (2009). Food insecurity is associated with incomplete HIV RNA suppression among homeless and marginally housed HIV-infected individuals in San Francisco. JGIM: Journal of General Internal Medicine, 24, 14–20.CrossRefPubMedGoogle Scholar
  40. 40.
    Weiser, S. D., Palar, K., Frongillo, E. A., Tsai, A. C., & Kumbakumba, E. (2014). Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda. AIDS (London, England), 28, 115.CrossRefGoogle Scholar
  41. 41.
    Weiser, S. D., Tuller, D. M., Frongillo, E. A., Senkungu, J., Mukiibi, N., & Bangsberg, D. R. (2010). Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. PLoS One, 5, e10340.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Weiser SD, Young SL, Cohen CR, Kushel MB, Tsai AC, Tien PC, et al. (2011). Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. The American Journal of Clinical Nutrition, 94, 1729 S–1739 S.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Young, S., Wheeler, A., McCoy, S., & Weiser, S. (2014). A review of the role of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS. AIDS & Behavior, 18, 505–515.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.School of Health and Social Development, Faculty of HealthDeakin UniversityMelbourneAustralia

Personalised recommendations