This review explores the relationship between HIV, poverty and food security, discuss vulnerable populations that are especially impacted by both food insecurity and HIV, and highlight research and policy implications to improve the food security and nutritional health of PLHA.
Food security is a key determinant of health, and is achieved when all people have the physical and economic means to access, at all times, sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.
Good nutritional status is critically important for immune function and maintaining the health of people living with HIV/AIDS (PLHA), however many PLHA live in poverty and have difficulty accessing affordable, nutritious food. The prevalence of food insecurity in PLHA in resource-rich settings (such as Canada) ranges from 49% to 71%.
A vicious cycle can ensue where HIV/AIDS and food insecurity worsen the severity of each other through nutritional, mental health and behavioural pathways.
Certain population groups are at greater risk of entering the HIV-food insecurity cycle including Aboriginal Canadians, women who are single parents and caring for dependent children or other family members, and elderly PLHA living in poverty.
Appropriate community-based strategies to improve food access and upstream policy approaches to address inequities may have the most promising chance of decreasing transmission and improving nutritional, mental health and behavioural outcomes associated with HIV.