Anna M Leddy1,2, Annelys Roque3, Lila A Sheira2, Edward A Frongillo4, Alan L Landay5, Adebola A Adedimeji6, Tracey E Wilson7, Daniel Merenstein8, Eryka Wentz9, Adaora A Adimora10, Igho Ofotokun11, Lisa R Metsch12, Mardge H Cohen13, Phyllis C Tien3, Janet M Turan14, Bulent Turan15, Sheri D Weiser1,2. 1. Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco. 2. Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco. 3. Department of Medicine, University of California San Francisco. 4. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia. 5. Department of Microbial Pathogens and Immunity, Rush University Medical Center, Chicago, Illinois. 6. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York. 7. Department of Community Health Sciences, School of Public Health, SUNY Downstate, Brooklyn, New York. 8. Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia. 9. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 10. School of Medicine, University of North Carolina at Chapel Hill, North Carolina. 11. Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. 12. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. 13. Division of General Internal Medicine, Cook County Health and Hospital System, Chicago, Illinois. 14. Department of Health Care Organization and Policy, School of Public Health. 15. Department of Psychology, University of Alabama at Birmingham.
Abstract
Background: Chronic inflammation is associated with AIDS-defining and non-AIDS-defining conditions. Limited research has considered how food insecurity influences chronic inflammation among people living with human immunodeficiency virus (HIV). We examined whether food insecurity was associated with higher levels of inflammation among women living with HIV (WWH) in the United States. Methods: We analyzed cross-sectional data collected in 2015 from 421 participants on antiretroviral therapy from the Women's Interagency HIV Study. The exposure was any food insecurity. The outcome was inflammation, measured by proinflammatory cytokine interleukin-6 (IL-6) and tumor necroses factor receptor 1 (TNFR1) levels. We conducted multivariable linear regressions, adjusting for sociodemographic, clinical, and nutritional factors. Results: Nearly one-third of participants (31%) were food insecure and 79% were virally suppressed (<20 copies/mL). In adjusted analyses, food insecurity was associated with 1.23 times the level of IL-6 (95% confidence interval [CI], 1.06-1.44) and 1.13 times the level of TNFR1 (95% CI, 1.05-1.21). Findings did not differ by HIV control (virally suppressed with CD4 counts ≥500 cells/mm3 or not) in adjusted stratified analyses. Conclusion: Food insecurity was associated with elevated inflammation among WWH regardless of HIV control. Findings support the need for programs that address food insecurity among WWH.
Background: Chronic inflammation is associated with AIDS-defining and non-AIDS-defining conditions. Limited research has considered how food insecurity influences chronic inflammation among people living with human immunodeficiency virus (HIV). We examined whether food insecurity was associated with higher levels of inflammation among women living with HIV (WWH) in the United States. Methods: We analyzed cross-sectional data collected in 2015 from 421 participants on antiretroviral therapy from the Women's Interagency HIV Study. The exposure was any food insecurity. The outcome was inflammation, measured by proinflammatory cytokine interleukin-6 (IL-6) and tumor necroses factor receptor 1 (TNFR1) levels. We conducted multivariable linear regressions, adjusting for sociodemographic, clinical, and nutritional factors. Results: Nearly one-third of participants (31%) were food insecure and 79% were virally suppressed (<20 copies/mL). In adjusted analyses, food insecurity was associated with 1.23 times the level of IL-6 (95% confidence interval [CI], 1.06-1.44) and 1.13 times the level of TNFR1 (95% CI, 1.05-1.21). Findings did not differ by HIV control (virally suppressed with CD4 counts ≥500 cells/mm3 or not) in adjusted stratified analyses. Conclusion: Food insecurity was associated with elevated inflammation among WWH regardless of HIV control. Findings support the need for programs that address food insecurity among WWH.
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