Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS
Open accessAbstract
Food insecurity, which affects >1 billion people worldwide, is inextricably linked to the HIV epidemic. We present a conceptual framework of the multiple pathways through which food insecurity and HIV/AIDS may be linked at the community, household, and individual levels. Whereas the mechanisms through which HIV/AIDS can cause food insecurity have been fairly well elucidated, the ways in which food insecurity can lead to HIV are less well understood. We argue that there are nutritional, mental health, and behavioral pathways through which food insecurity leads to HIV acquisition and disease progression. Specifically, food insecurity can lead to macronutrient and micronutrient deficiencies, which can affect both vertical and horizontal transmission of HIV, and can also contribute to immunologic decline and increased morbidity and mortality among those already infected. Food insecurity can have mental health consequences, such as depression and increased drug abuse, which, in turn, contribute to HIV transmission risk and incomplete HIV viral load suppression, increased probability of AIDS-defining illness, and AIDS-related mortality among HIV-infected individuals. As a result of the inability to procure food in socially or personally acceptable ways, food insecurity also contributes to risky sexual practices and enhanced HIV transmission, as well as to antiretroviral therapy nonadherence, treatment interruptions, and missed clinic visits, which are strong determinants of worse HIV health outcomes. More research on the relative importance of each of these pathways is warranted because effective interventions to reduce food insecurity and HIV depend on a rigorous understanding of these multifaceted relationships.
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Food insecurity contributes to risky sexual practices and enhanced transmission of HIV.
“Food-insecurity, for instance, contributes to risky sexual practices and enhanced transmission of HIV.”
From Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries (2019) · cites this paper as [14]
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Flagged first, then by citations
Research works printed but not linked: 4
- Weiser SD, Tsai AC, Senkungu J, Emenyonu N, Kawuma A, Hunt P, Geng E, Martin J, Bangsberg DR. Food insecurity and morbidity among HIV-Infected persons accessing antiretroviral therapy (ART) in rural Uganda. XVIII International AIDS Conference. Vienna, Austria, 2010.
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Food insecurity, HIV disease progression and access to care among HIV-infected Russians not on ART
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Self-citation
- Authors
- Weiser, S. D., Young, S. L., Cohen, C. R., Kushel, M. B., Tsai, A. C., Tien, P. C., Hatcher, A. M., Frongillo, E. A., & Bangsberg, D. R.
- Affiliations
- San Francisco General Hospital (US)
- University of California, San Francisco (US)
- Harvard University (US)
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 94
- Issue
- 6
- Pages
- 1729S-1739S
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3226026
- OpenAlex
- W2155569064
- Cited by
- 449
- References
- 188
- Citations by year
- 2026: 13 · 2025: 21 · 2024: 30 · 2023: 28 · 2022: 33 · 2021: 47 · 2020: 33 · 2019: 28 · 2018: 42 · 2017: 41 · 2016: 31 · 2015: 34 · 2014: 28 · 2013: 23 · 2012: 13
- FWCI
- 39.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- California HIV/AIDS Research Program
- National Institutes of Health (5k23mh079713-05)
- University of California, San Francisco
- National Institute of Mental Health (MH 54907, R01MH054907, K24MH087227, MH79713-01, MH87227)
- National Institute of Allergy and Infectious Diseases (P30AI027763)
- Topics
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Agricultural and Biological Sciences › General Agricultural and Biological Sciences › Food Security and Socioeconomic Dynamics
- Keywords
- food insecurity, HIV/AIDS, bidirectional relationship, micronutrient deficiency, macronutrient deficiency, vertical transmission, horizontal transmission, depression, drug abuse, sexual risk behavior, antiretroviral therapy adherence, HIV disease progression, AIDS mortality
- MeSH terms
- Mental Disorders, Depression, Diet, Family Characteristics, Food Supply, Health Status, Humans, Immunity, Nutritional Status, Patient Compliance, Residence Characteristics, Risk Factors, Risk-Taking, Sexual Behavior, HIV Infections, Micronutrients, Anti-HIV Agents, Viral Load, Substance-Related Disorders, Malnutrition
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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