Food insecurity among people who inject drugs in Athens, Greece: A study in the context of ARISTOTLE programme

Abstract

Objective: To measure the prevalence of food insecurity and explore related characteristics and behaviours among people who inject drugs (PWID). Design: Cross-sectional analysis of a community-based programme for HIV infection among PWID (ARISTOTLE programme). Food insecurity was measured by the Household Food Insecurity Access Scale. Computer-assisted interviews and blood samples were also collected. Setting: A fixed location in Athens Metropolitan Area, Greece, during 2012-2013. Participants: In total, 2834 unique participants with history of injecting drug use in the past 12 months were recruited over four respondent-driven sampling rounds (approximately 1400/round). Results: More than 50 % of PWID were severely or moderately food insecure across all rounds. PWID were more likely to be severely food insecure if they were older than 40 years [adjusted OR (aOR): 1.71, 95 % CI: 1.33-2.19], were women (aOR: 1.49, 95 % CI: 1.17-1.89), from Middle East countries (aOR v. from Greece: 1.80, 95 % CI: 1.04-3.11), had a lower educational level (primary or secondary school v. higher education; aOR: 1.54, 95 % CI: 1.29-1.84), had no current health insurance (aOR: 1.45, 95 % CI: 1.21-1.73), were homeless (aOR: 17.1, 95 % CI: 12.3-23.8) or were living with another drug user (aOR: 1.55, 95 % CI: 1.26-1.91) as compared with those living alone or with family/friends. HIV-infected PWID were more likely to be severely food insecure compared with uninfected (59.0 % v. 51.0 %, respectively, P = 0.002); however, this difference was attributed to the confounding effect of homelessness. Conclusions: Moderate/severe food insecurity was a significant problem, reaching > 50 % in this sample of PWID and closely related to socio-demographic characteristics and especially homelessness.