Impact of Food Insecurity on Depressive Symptoms Among HIV–HCV Co-infected People

Abstract

Food insecurity (FI) is associated with depressive symptoms among HIV mono-infected people. Our objective was to examine to what extent this association holds among HIV–hepatitis C virus (HCV) co-infected people. We used data from a prospective cohort study of HIV–HCV co-infected people in Canada. FI was measured using the ten-item adult scale of Health Canada’s Household Food Security Survey Module and was classified into three categories: food secure, moderate FI, and severe FI. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10) and was classified into absence or presence of depressive symptoms. FI, depressive symptoms, and other covariates were updated every 6 months. The association between FI and depressive symptoms was assessed using a stabilized inverse probability weighted marginal structural model. The study sample included 725 HIV–HCV co-infected people with 1973 person-visits over 3 years of follow up. At baseline, 23% of participants experienced moderate food insecurity, 34% experienced severe food insecurity and 52% had depressive symptoms. People experiencing moderate FI had 1.63 times (95% CI 1.44–1.86) the risk of having depressive symptoms and people experiencing severe FI had 2.01 times (95% CI 1.79–2.25) the risk of having depressive symptoms compared to people who were food secure. FI is a risk factor for developing depressive symptoms among HIV–HCV co-infected people. Food supplementation, psychosocial support and counseling may improve patient health outcomes.