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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting</title><author><name sortKey="Weiser, Sheri D" sort="Weiser, Sheri D" uniqKey="Weiser S" first="Sheri D." last="Weiser">Sheri D. Weiser</name><affiliation><nlm:aff id="A1">Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Tsai, Alexander C" sort="Tsai, Alexander C" uniqKey="Tsai A" first="Alexander C." last="Tsai">Alexander C. Tsai</name><affiliation><nlm:aff id="A2">Robert Wood Johnson Health and Society Scholars Program, Harvard University, Cambridge, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Gupta, Reshma" sort="Gupta, Reshma" uniqKey="Gupta R" first="Reshma" last="Gupta">Reshma Gupta</name><affiliation><nlm:aff id="A3">Department of Internal Medicine, University of Washington, Seattle; Seattle, Washington</nlm:aff></affiliation></author><author><name sortKey="Frongillo, Edward A" sort="Frongillo, Edward A" uniqKey="Frongillo E" first="Edward A." last="Frongillo">Edward A. Frongillo</name><affiliation><nlm:aff id="A4">Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina</nlm:aff></affiliation></author><author><name sortKey="Kawuma, Annet" sort="Kawuma, Annet" uniqKey="Kawuma A" first="Annet" last="Kawuma">Annet Kawuma</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Senkungu, Jude" sort="Senkungu, Jude" uniqKey="Senkungu J" first="Jude" last="Senkungu">Jude Senkungu</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W." last="Hunt">Peter W. Hunt</name><affiliation><nlm:aff id="A1">Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Emenyonu, Nneka I" sort="Emenyonu, Nneka I" uniqKey="Emenyonu N" first="Nneka I." last="Emenyonu">Nneka I. Emenyonu</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Mattson, Jennifer E" sort="Mattson, Jennifer E" uniqKey="Mattson J" first="Jennifer E." last="Mattson">Jennifer E. Mattson</name><affiliation><nlm:aff id="A1">Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N." last="Martin">Jeffrey N. Martin</name><affiliation><nlm:aff id="A7">Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R." last="Bangsberg">David R. Bangsberg</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21904186</idno><idno type="pmc">3606954</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3606954</idno><idno type="RBID">PMC:3606954</idno><idno type="doi">10.1097/QAD.0b013e32834cad37</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">001D44</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D44</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting</title><author><name sortKey="Weiser, Sheri D" sort="Weiser, Sheri D" uniqKey="Weiser S" first="Sheri D." last="Weiser">Sheri D. Weiser</name><affiliation><nlm:aff id="A1">Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Tsai, Alexander C" sort="Tsai, Alexander C" uniqKey="Tsai A" first="Alexander C." last="Tsai">Alexander C. Tsai</name><affiliation><nlm:aff id="A2">Robert Wood Johnson Health and Society Scholars Program, Harvard University, Cambridge, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Gupta, Reshma" sort="Gupta, Reshma" uniqKey="Gupta R" first="Reshma" last="Gupta">Reshma Gupta</name><affiliation><nlm:aff id="A3">Department of Internal Medicine, University of Washington, Seattle; Seattle, Washington</nlm:aff></affiliation></author><author><name sortKey="Frongillo, Edward A" sort="Frongillo, Edward A" uniqKey="Frongillo E" first="Edward A." last="Frongillo">Edward A. Frongillo</name><affiliation><nlm:aff id="A4">Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina</nlm:aff></affiliation></author><author><name sortKey="Kawuma, Annet" sort="Kawuma, Annet" uniqKey="Kawuma A" first="Annet" last="Kawuma">Annet Kawuma</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Senkungu, Jude" sort="Senkungu, Jude" uniqKey="Senkungu J" first="Jude" last="Senkungu">Jude Senkungu</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation></author><author><name sortKey="Hunt, Peter W" sort="Hunt, Peter W" uniqKey="Hunt P" first="Peter W." last="Hunt">Peter W. Hunt</name><affiliation><nlm:aff id="A1">Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Emenyonu, Nneka I" sort="Emenyonu, Nneka I" uniqKey="Emenyonu N" first="Nneka I." last="Emenyonu">Nneka I. Emenyonu</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Mattson, Jennifer E" sort="Mattson, Jennifer E" uniqKey="Mattson J" first="Jennifer E." last="Mattson">Jennifer E. Mattson</name><affiliation><nlm:aff id="A1">Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Martin, Jeffrey N" sort="Martin, Jeffrey N" uniqKey="Martin J" first="Jeffrey N." last="Martin">Jeffrey N. Martin</name><affiliation><nlm:aff id="A7">Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Bangsberg, David R" sort="Bangsberg, David R" uniqKey="Bangsberg D" first="David R." last="Bangsberg">David R. Bangsberg</name><affiliation><nlm:aff id="A5">Mbarara University of Science and Technology, Mbarara, Uganda</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author></analytic><series><title level="j">AIDS (London, England)</title><idno type="ISSN">0269-9370</idno><idno type="eISSN">1473-5571</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">We undertook a longitudinal study in rural Uganda to understand the association of food insecurity with morbidity and patterns of healthcare utilization among HIV-infected individuals enrolled in an antiretroviral therapy program.</p></sec><sec id="S2"><title>Design</title><p id="P2">Longitudinal cohort study.</p></sec><sec id="S3"><title>Methods</title><p id="P3">Participants were enrolled from the Uganda AIDS Rural Treatment Outcomes cohort, and underwent quarterly structured interviews and blood draws. The primary predictor was food insecurity measured by the validated Household Food Insecurity Access Scale. Primary outcomes included health-related quality of life measured by the validated Medical Outcomes Study-HIV Physical Health Summary (PHS), incident self-reported opportunistic infections, number of hospitalizations, and missed clinic visits. To estimate model parameters, we used the method of generalized estimating equations, adjusting for sociodemographic and clinical variables. Explanatory variables were lagged by 3 months to strengthen causal interpretations.</p></sec><sec id="S4"><title>Results</title><p id="P4">Beginning in May 2007, 458 persons were followed for a median of 2.07 years, and 40% were severely food insecure at baseline. Severe food insecurity was associated with worse PHS, opportunistic infections, and increased hospitalizations (results were similar in concurrent and lagged models). Mild/moderate food insecurity was associated with missed clinic visits in concurrent models, whereas in lagged models, severe food insecurity was associated with reduced odds of missed clinic visits.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">Based on the negative impact of food insecurity on morbidity and patterns of healthcare utilization among HIV-infected individuals, policies and programs that address food insecurity should be a critical component of HIV treatment programs worldwide.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8710219</journal-id><journal-id journal-id-type="pubmed-jr-id">1493</journal-id><journal-id journal-id-type="nlm-ta">AIDS</journal-id><journal-id journal-id-type="iso-abbrev">AIDS</journal-id><journal-title-group><journal-title>AIDS (London, England)</journal-title></journal-title-group><issn pub-type="ppub">0269-9370</issn><issn pub-type="epub">1473-5571</issn></journal-meta><article-meta><article-id pub-id-type="pmid">21904186</article-id><article-id pub-id-type="pmc">3606954</article-id><article-id pub-id-type="doi">10.1097/QAD.0b013e32834cad37</article-id><article-id pub-id-type="manuscript">NIHMS447668</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Food insecurity is associated with morbidity and patterns of healthcare utilization among HIV-infected individuals in a resource-poor setting</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Weiser</surname><given-names>Sheri D.</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Tsai</surname><given-names>Alexander C.</given-names></name><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Gupta</surname><given-names>Reshma</given-names></name><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Frongillo</surname><given-names>Edward A.</given-names></name><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Kawuma</surname><given-names>Annet</given-names></name><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Senkungu</surname><given-names>Jude</given-names></name><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Hunt</surname><given-names>Peter W.</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Emenyonu</surname><given-names>Nneka I.</given-names></name><xref ref-type="aff" rid="A5">e</xref><xref ref-type="aff" rid="A6">f</xref></contrib><contrib contrib-type="author"><name><surname>Mattson</surname><given-names>Jennifer E.</given-names></name><xref ref-type="aff" rid="A1">a</xref></contrib><contrib contrib-type="author"><name><surname>Martin</surname><given-names>Jeffrey N.</given-names></name><xref ref-type="aff" rid="A7">g</xref></contrib><contrib contrib-type="author"><name><surname>Bangsberg</surname><given-names>David R.</given-names></name><xref ref-type="aff" rid="A5">e</xref><xref ref-type="aff" rid="A6">f</xref></contrib></contrib-group><aff id="A1"><label>a</label>Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California</aff><aff id="A2"><label>b</label>Robert Wood Johnson Health and Society Scholars Program, Harvard University, Cambridge, Massachusetts</aff><aff id="A3"><label>c</label>Department of Internal Medicine, University of Washington, Seattle; Seattle, Washington</aff><aff id="A4"><label>d</label>Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina</aff><aff id="A5"><label>e</label>Mbarara University of Science and Technology, Mbarara, Uganda</aff><aff id="A6"><label>f</label>Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard Medical School, Boston, Massachusetts</aff><aff id="A7"><label>g</label>Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California</aff><author-notes><corresp id="FN1">Correspondence to Sheri Weiser, MD, MPH, Division of HIV/AIDS, San Francisco General Hospital, POB 0874, UCSF, San Francisco, CA 94143, USA. Tel: +1 415 314 0665; fax: +1 415 869 5395; <email>Sheri.Weiser@ucsf.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>26</day><month>2</month><year>2013</year></pub-date><pub-date pub-type="ppub"><day>2</day><month>1</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>25</day><month>3</month><year>2013</year></pub-date><volume>26</volume><issue>1</issue><fpage>67</fpage><lpage>75</lpage><permissions><copyright-statement>Copyright © Lippincott Williams & Wilkins.</copyright-statement></permissions><abstract><sec id="S1"><title>Objective</title><p id="P1">We undertook a longitudinal study in rural Uganda to understand the association of food insecurity with morbidity and patterns of healthcare utilization among HIV-infected individuals enrolled in an antiretroviral therapy program.</p></sec><sec id="S2"><title>Design</title><p id="P2">Longitudinal cohort study.</p></sec><sec id="S3"><title>Methods</title><p id="P3">Participants were enrolled from the Uganda AIDS Rural Treatment Outcomes cohort, and underwent quarterly structured interviews and blood draws. The primary predictor was food insecurity measured by the validated Household Food Insecurity Access Scale. Primary outcomes included health-related quality of life measured by the validated Medical Outcomes Study-HIV Physical Health Summary (PHS), incident self-reported opportunistic infections, number of hospitalizations, and missed clinic visits. To estimate model parameters, we used the method of generalized estimating equations, adjusting for sociodemographic and clinical variables. Explanatory variables were lagged by 3 months to strengthen causal interpretations.</p></sec><sec id="S4"><title>Results</title><p id="P4">Beginning in May 2007, 458 persons were followed for a median of 2.07 years, and 40% were severely food insecure at baseline. Severe food insecurity was associated with worse PHS, opportunistic infections, and increased hospitalizations (results were similar in concurrent and lagged models). Mild/moderate food insecurity was associated with missed clinic visits in concurrent models, whereas in lagged models, severe food insecurity was associated with reduced odds of missed clinic visits.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">Based on the negative impact of food insecurity on morbidity and patterns of healthcare utilization among HIV-infected individuals, policies and programs that address food insecurity should be a critical component of HIV treatment programs worldwide.</p></sec></abstract><kwd-group><kwd>AIDS</kwd><kwd>food insecurity</kwd><kwd>healthcare utilization</kwd><kwd>HIV</kwd><kwd>morbidity</kwd><kwd>Uganda</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source><award-id>R01 MH054907 || MH</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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