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Food security and antiretroviral therapy adherence among people living with HIV in Lundazi District, Zambia: A pilot study.

机译：赞比亚Lundazi区艾滋病毒感染者中食品安全和抗逆转录病毒疗法依从性的一项试点研究。

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摘要

Food security, or adequate access to food at all times, is critical to the health and well-being of people living with HIV (PLHIV). Research has shown that food insecurity is associated with suboptimal adherence to antiretroviral therapy (ART). Nonadherence, in turn, predicts adverse health outcomes, including higher risk of mortality. However, evidence remains limited on the prevalence, correlates and effects of food insecurity on treatment adherence, as well as appropriate strategies to improve food security in rural and resource-limited settings. This dissertation aims to: 1) expand the literature on food insecurity and ART adherence in resource-limited settings, particularly in rural communities; and 2) examine the effectiveness of an income-generating strategy to increase food security and treatment adherence among PLHIV in Lundazi District, Eastern Province, Zambia. The study sample included 101 PLHIV who were attending two health facilities in Lundazi District and participating in a pilot integrated HIV and livelihood program. Consistent with prior research, food insecurity was highly prevalent among the study sample. Ninety-three and 95 percent of the sample were food insecure at baseline and follow-up, respectively. In addition, at least 70% of the sample was severely food-insecure at both time points. In this rural sample of PLHIV, food insecurity was predicted by lack of economic security in the household. Lower income, fewer assets, and having debts were significantly associated with food insecurity. Results also indicated an inverse, albeit not statistically significant, association between food insecurity and treatment adherence. Food-insecure PLHIV were less likely to achieve optimal treatment adherence contrasted with food-secure PLHIV. Finally, participation in a livelihood program contributed to statistically significant increase in food security, as well as positive effect on treatment adherence. Findings suggest that food security can be improved using a promising intervention that targets underlying social and economic determinants of food insecurity among PLHIV. Implications of findings for social work policy, practice, and research, as well as key study limitations, are discussed.
机译：粮食安全或任何时候都有充足的食物，对于艾滋病毒携带者（PLHIV）的健康和福祉至关重要。研究表明，食品不安全与抗逆转录病毒治疗（ART）依从性差有关。反之，不依从可以预测不利的健康结果，包括更高的死亡风险。但是，关于粮食不安全状况对治疗依从性的普遍性，相关性和影响以及在农村和资源有限的环境中改善粮食安全的适当策略的证据仍然有限。本文旨在：1）在资源有限的环境中，特别是在农村社区，扩大有关粮食不安全和抗逆转录病毒依从性的文献； 2）在赞比亚东部省隆达兹县，研究一种创收战略在提高艾滋病毒/艾滋病感染者的粮食安全和治疗依从性方面的有效性。该研究样本包括101名PLHIV感染者，他们正在Lundazi区的两个医疗机构就诊，并参加了艾滋病毒和生计综合试点项目。与先前的研究一致，食物不安全在研究样本中非常普遍。在基线和随访中，分别有93％和95％的样品没有食物保障。此外，在两个时间点，至少有70％的样品严重缺乏食物。在这个农村地区的艾滋病病毒感染者样本中，由于家庭缺乏经济安全性而预测了粮食不安全。较低的收入，较少的资产以及欠债与粮食不安全状况密切相关。结果还表明，粮食不安全状况与治疗依从性之间存在逆相关关系，尽管在统计学上不显着。与食品安全的PLHIV相比，食品安全的PLHIV不太可能获得最佳治疗依从性。最后，参与一项生计计划在统计学上显着提高了粮食安全，并对依从性产生了积极影响。研究结果表明，可以通过有前途的干预措施来改善粮食安全，该干预措施针对的是艾滋病毒携带者中粮食不安全的潜在社会和经济决定因素。讨论了研究结果对社会工作政策，实践和研究的意义以及主要研究的局限性。

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  • 作者

    Masa, Rainier DeVera.;

  • 作者单位

    The University of North Carolina at Chapel Hill.;

  • 授予单位 The University of North Carolina at Chapel Hill.;
  • 学科 Social work.;South African studies.
  • 学位 Ph.D.
  • 年度 2016
  • 页码 302 p.
  • 总页数 302
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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