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The association between food insecurity and mortality among HIV-infected individuals on HAART.

https://arctichealth.org/en/permalink/ahliterature149141
Source
J Acquir Immune Defic Syndr. 2009 Nov 1;52(3):342-9
Publication Type
Article
Date
Nov-1-2009
Author
Sheri D Weiser
Kimberly A Fernandes
Eirikka K Brandson
Viviane D Lima
Aranka Anema
David R Bangsberg
Julio S Montaner
Robert S Hogg
Author Affiliation
Department of Medicine, Positive Health Program, San Francisco General Hospital, University of California San Francisco, San Francisco, CA 94143-1372, USA. sheri.weiser@ucsf.edu
Source
J Acquir Immune Defic Syndr. 2009 Nov 1;52(3):342-9
Date
Nov-1-2009
Language
English
Publication Type
Article
Keywords
Adult
Antiretroviral Therapy, Highly Active
British Columbia - epidemiology
Female
Food Supply - statistics & numerical data
HIV Infections - drug therapy - epidemiology - mortality
Health Surveys
Humans
Male
Middle Aged
Poverty
Risk factors
Thinness
Abstract
Food insecurity is increasingly recognized as a barrier to optimal treatment outcomes, but there is little data on this issue. We assessed associations between food insecurity and mortality among HIV-infected antiretroviral therapy-treated individuals in Vancouver, British Columbia, and whether body max index (BMI) modified associations.
Individuals were recruited from the British Columbia HIV/AIDS drug treatment program in 1998 and 1999 and were followed until June 2007 for outcomes. Food insecurity was measured with the Radimer/Cornell questionnaire. Cox proportional hazard models were used to determine associations between food insecurity, BMI, and nonaccidental deaths when controlling for confounders.
Among 1119 participants, 536 (48%) were categorized as food insecure and 160 (14%) were categorized as underweight (BMI
Notes
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PubMed ID
19675463 View in PubMed
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Expanded access to highly active antiretroviral therapy: a potentially powerful strategy to curb the growth of the HIV epidemic.

https://arctichealth.org/en/permalink/ahliterature157052
Source
J Infect Dis. 2008 Jul 1;198(1):59-67
Publication Type
Article
Date
Jul-1-2008
Author
Viviane D Lima
Karissa Johnston
Robert S Hogg
Adrian R Levy
P Richard Harrigan
Aranka Anema
Julio S G Montaner
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, British Columbia, Canada.
Source
J Infect Dis. 2008 Jul 1;198(1):59-67
Date
Jul-1-2008
Language
English
Publication Type
Article
Keywords
Anti-HIV Agents - administration & dosage - economics - therapeutic use
Antiretroviral Therapy, Highly Active - economics - utilization
British Columbia - epidemiology
CD4 Lymphocyte Count
Delivery of Health Care - economics
Disease Outbreaks
Drug Resistance, Viral
HIV Infections - drug therapy - epidemiology - transmission
HIV-1 - genetics - isolation & purification
Humans
Models, Biological
Poverty
Probability
RNA, Viral - blood
Socioeconomic Factors
Abstract
We developed a mathematical model using a multiple source of infection framework to assess the potential effect of the expansion of highly active antiretroviral therapy (HAART) coverage among those in medical need on the number of individuals testing newly positive for human immunodeficiency virus (HIV) and on related costs in British Columbia, Canada, over the next 25 years. The model was calibrated using retrospective data describing antiretroviral therapy utilization and individuals testing newly positive for HIV in the province. Different scenarios were investigated on the basis of varying assumptions regarding drug resistance, adherence to HAART, therapeutic guidelines, degree of HAART coverage, and the timing of HAART uptake. Expansion of HAART lead to substantial reductions in the growth of the HIV epidemic and related costs. These results provide powerful additional motivation to accelerate the roll out of HAART programs aggressively targeting those in medical need, both for their own benefit and as a means of decreasing new HIV infections.
PubMed ID
18498241 View in PubMed
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Factors behind HIV testing practices among Canadian Aboriginal peoples living off-reserve.

https://arctichealth.org/en/permalink/ahliterature144229
Source
AIDS Care. 2010 Mar;22(3):324-31
Publication Type
Article
Date
Mar-2010
Author
Treena R Orchard
Eric Druyts
Colin W McInnes
Ken Clement
Erin Ding
Kimberly A Fernandes
Aranka Anema
Viviane D Lima
Robert S Hogg
Author Affiliation
Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.
Source
AIDS Care. 2010 Mar;22(3):324-31
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
AIDS Serodiagnosis - statistics & numerical data
Adolescent
Adult
Age Factors
Alcohol drinking - epidemiology
Attitude to Health - ethnology
Canada - epidemiology
Epidemiologic Methods
Female
Government Programs
HIV Infections - ethnology - prevention & control
Health Behavior
Health status
Humans
Indians, North American - statistics & numerical data
Male
Sex Factors
Sexual Behavior
Smoking - epidemiology
Socioeconomic Factors
Substance Abuse, Intravenous - epidemiology
Young Adult
Abstract
The objective of this study was to examine factors associated with HIV testing among Aboriginal peoples in Canada who live off-reserve. Data were drawn for individuals aged 15-44 from the Aboriginal Peoples Survey (2001), which represents a weighed sample of 520,493 Aboriginal men and women living off-reserve. Bivariable analysis and logistic regression were used to identify factors associated with individuals who had received an HIV test within the past year. In adjusted multivariable analysis, female gender, younger age, unemployment, contact with a family doctor or traditional healer within the past year, and "good" or "fair/poor" self-rated health increased the odds of HIV testing. Completion of high-school education, rural residency, and less frequent alcohol and cigarette consumption decreased the odds of HIV testing. A number of differences emerged when the sample was analyzed by gender, most notably females who self-reported "good" or "fair/poor" health status were more likely to have had an HIV test, yet males with comparable health status were less likely to have had an HIV test. Additionally, frequent alcohol consumption and less than high-school education was associated with an increased odds of HIV testing among males, but not females. Furthermore, while younger age was associated with an increased odds of having an HIV test in the overall model, this was particularly relevant for females aged 15-24. These outcomes provide evidence of the need for improved HIV testing strategies to reach greater numbers of Aboriginal peoples living off-reserve. They also echo the long-standing call for culturally appropriate HIV-related programming while drawing new attention to the importance of gender and age, two factors that are often generalized under the rubric of culturally relevant or appropriate program development.
PubMed ID
20390512 View in PubMed
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Food insecurity and hunger are prevalent among HIV-positive individuals in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature175528
Source
J Nutr. 2005 Apr;135(4):820-5
Publication Type
Article
Date
Apr-2005
Author
Lena Normén
Keith Chan
Paula Braitstein
Aranka Anema
Greg Bondy
Julio S G Montaner
Robert S Hogg
Author Affiliation
Canadian HIV Trials Network, Pacific Region, St. Paul's Hospital, Vancouver, British Columbia, Canada. lnormen@providencehealth.bc.ca
Source
J Nutr. 2005 Apr;135(4):820-5
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adult
British Columbia - epidemiology
Educational Status
Employment
Female
Food Supply - statistics & numerical data
HIV Seropositivity - epidemiology - transmission
Health Surveys
Housing
Humans
Hunger - physiology
Income
Male
Middle Aged
Multivariate Analysis
Questionnaires
Regression Analysis
Abstract
Hunger and food insecurity are important factors that may affect an individual's nutritional state and should therefore be assessed in nutrition surveillance activities. The objective of this study was to determine the level of food insecurity and hunger among HIV-positive persons accessing antiretroviral therapy in British Columbia. A cross-sectional study was performed in the BC HIV/AIDS drug treatment program, a province-wide source of free-of-charge antiretroviral medications. In 1998-1999, participants completed a questionnaire focusing on personal information, health, and clinical status. Food and hunger issues were evaluated with the Radimer/Cornell questionnaire. Overall, 1213 responding men and women were classified as food secure (52%), food insecure without hunger (27%), or food insecure with hunger (21%). In both categories of food insecurity, individuals were significantly more likely to be women, aboriginals, living with children, and to have less education, a history of recreational injection drug and/or alcohol abuse, and an unstable housing situation (P
PubMed ID
15795441 View in PubMed
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Food insufficiency is associated with psychiatric morbidity in a nationally representative study of mental illness among food insecure Canadians.

https://arctichealth.org/en/permalink/ahliterature257037
Source
Soc Psychiatry Psychiatr Epidemiol. 2013 May;48(5):795-803
Publication Type
Article
Date
May-2013
Author
Katherine A Muldoon
Putu K Duff
Sarah Fielden
Aranka Anema
Author Affiliation
School of Population and Public Health, University of British Columbia, Vancouver, Canada. kmuldoon@alumni.ubc.ca
Source
Soc Psychiatry Psychiatr Epidemiol. 2013 May;48(5):795-803
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada - epidemiology
Confounding Factors (Epidemiology)
Female
Food Supply - standards - statistics & numerical data
Health Surveys
Humans
Hunger
Logistic Models
Male
Mental Disorders - diagnosis - epidemiology - psychology
Middle Aged
Prevalence
Residence Characteristics
Socioeconomic Factors
Transients and Migrants - psychology - statistics & numerical data
Young Adult
Abstract
Studies suggest that people who are food insecure are more likely to experience mental illness. However, little is known about which aspects of food insecurity place individuals most at risk of mental illness. The purpose of this study was to establish the prevalence of mental illness among food insecure Canadians, and examine whether mental illness differs between those who are consuming insufficient amounts of food versus poor quality foods.
This analysis utilized the publically available dataset from the Canadian Community Health Survey cycle 4.1. Bivariable and multivariable logistic regression were used to examine the associations between food insecurity and mental health disorder diagnosis, while adjusting for potential confounders. Stratified analyses were used to identify vulnerable sub-groups.
Among 5,588 Canadian adults (18-64 years) reporting food insecurity, 58 % reported poor food quality and 42 % reported food insufficiency. The prevalence of mental health diagnosis was 24 % among participants with poor food quality, and 35 % among individuals who were food insufficient (hunger). After adjusting for confounders, adults experiencing food insufficiency had 1.69 adjusted-odds [95 % confidence interval (CI): 1.49-1.91] of having a mental health diagnosis. Stratified analyses revealed increased odds among women (a-OR 1.89, 95 % CI 1.62-2.20), single parent households (a-OR 2.05, 95 % CI 1.51-2.78), and non-immigrants (a-OR 1.88, 95 % CI 1.64-2.16).
The prevalence of mental illness is alarmingly high in this population-based sample of food insecure Canadians. These findings suggest that government and community-based programming aimed at strengthening food security should integrate supports for mental illness in this population.
PubMed ID
23064395 View in PubMed
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Hunger and associated harms among injection drug users in an urban Canadian setting.

https://arctichealth.org/en/permalink/ahliterature141237
Source
Subst Abuse Treat Prev Policy. 2010;5:20
Publication Type
Article
Date
2010
Author
Aranka Anema
Evan Wood
Sheri D Weiser
Jiezhi Qi
Julio Sg Montaner
Thomas Kerr
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, Vancouver, BC, Canada.
Source
Subst Abuse Treat Prev Policy. 2010;5:20
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Canada
Cross-Sectional Studies
Female
Humans
Hunger
Male
Middle Aged
Substance Abuse, Intravenous
Urban Population
Abstract
Food insufficiency is often associated with health risks and adverse outcomes among marginalized populations. However, little is known about correlates of food insufficiency among injection drug users (IDU).
We conducted a cross-sectional study to examine the prevalence and correlates of self-reported hunger in a large cohort of IDU in Vancouver, Canada. Food insufficiency was defined as reporting "I am hungry, but don't eat because I can't afford enough food". Logistic regression was used to determine independent socio-demographic and drug-use characteristics associated with food insufficiency.
Among 1,053 participants, 681 (64.7%) reported being hungry and unable to afford enough food. Self-reported hunger was independently associated with: unstable housing (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.20 - 2.36, spending = $50/day on drugs (AOR: 1.43, 95% CI: 1.06 - 1.91), and symptoms of depression (AOR: 3.32, 95% CI: 2.45 - 4.48).
These findings suggest that IDU in this setting would likely benefit from interventions that work to improve access to food and social support services, including addiction treatment programs which may reduce the adverse effect of ongoing drug use on hunger.
Notes
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PubMed ID
20796313 View in PubMed
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Incidence of and risk factors for sexual orientation-related physical assault among young men who have sex with men.

https://arctichealth.org/en/permalink/ahliterature157476
Source
Am J Public Health. 2008 Jun;98(6):1028-35
Publication Type
Article
Date
Jun-2008
Author
Thomas M Lampinen
Keith Chan
Aranka Anema
Mary Lou Miller
Arn J Schilder
Martin T Schechter
Robert Stephen Hogg
Steffanie A Strathdee
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Source
Am J Public Health. 2008 Jun;98(6):1028-35
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aggression
Bisexuality
British Columbia
Chi-Square Distribution
Homosexuality, Male
Humans
Incidence
Logistic Models
Male
Prejudice
Prevalence
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk factors
Sexual Behavior
Abstract
We sought to determine incidence of, prevalence of, and risk factors for sexual orientation-related physical assault in young men who have sex with men (MSM).
We completed a prospective open cohort study of young MSM in Vancouver, British Columbia, surveyed annually between 1995 and 2004. Correlates of sexual orientation-related physical assault before enrollment were identified with logistic regression. Risk factors for incident assaults were determined with Cox regression.
At enrollment, 84 (16%) of 521 MSM reported ever experiencing assault related to actual or perceived sexual orientation. Incidence was 2.3 per 100 person-years; cumulative incidence at 6-year follow-up was 10.8 per 100 person-years. Increased risk of incident sexual orientation-related physical assault was observed among MSM 23 years or younger (relative hazard=3.1; 95% confidence interval [CI] = 1.6, 5.8), Canadian Aboriginal people (relative hazard = 3.0; 95% CI=1.4, 6.2), and those who previously experienced such assault (relative hazard=2.5; 95% CI=1.3, 4.8).
These data underscore the need for increased public awareness, surveillance, and support to reduce assault against young MSM. Such efforts should be coordinated at the community level to ensure that social norms dictate that such acts are unacceptable.
Notes
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PubMed ID
18445793 View in PubMed
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Relationship between food insecurity and mortality among HIV-positive injection drug users receiving antiretroviral therapy in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature113453
Source
PLoS One. 2013;8(5):e61277
Publication Type
Article
Date
2013
Author
Aranka Anema
Keith Chan
Yalin Chen
Sheri Weiser
Julio S G Montaner
Robert S Hogg
Author Affiliation
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada. aanema@cfenet.ubc.ca
Source
PLoS One. 2013;8(5):e61277
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active
British Columbia - epidemiology
Drug users
Female
Food Supply
HIV Infections - drug therapy - mortality
Humans
Incidence
Male
Multivariate Analysis
Abstract
Little is known about the potential impact of food insecurity on mortality among people living with HIV/AIDS. We examined the potential relationship between food insecurity and all-cause mortality among HIV-positive injection drug users (IDU) initiating antiretroviral therapy (ART) across British Columbia (BC).
Cross-sectional measurement of food security status was taken at participant ART initiation. Participants were prospectively followed from June 1998 to September 2011 within the fully subsidized ART program. Cox proportional hazard models were used to ascertain the association between food insecurity and mortality, controlling for potential confounders.
Among 254 IDU, 181 (71.3%) were food insecure and 108 (42.5%) were hungry. After 13.3 years of median follow-up, 105 (41.3%) participants died. In multivariate analyses, food insecurity remained significantly associated with mortality (adjusted hazard ratio [AHR]?=?1.95, 95% CI: 1.07-3.53), after adjusting for potential confounders.
HIV-positive IDU reporting food insecurity were almost twice as likely to die, compared to food secure IDU. Further research is required to understand how and why food insecurity is associated with excess mortality in this population. Public health organizations should evaluate the possible role of food supplementation and socio-structural supports for IDU within harm reduction and HIV treatment programs.
Notes
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PubMed ID
23723968 View in PubMed
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Relationship between hunger, adherence to antiretroviral therapy and plasma HIV RNA suppression among HIV-positive illicit drug users in a Canadian setting.

https://arctichealth.org/en/permalink/ahliterature107393
Source
AIDS Care. 2014 Apr;26(4):459-65
Publication Type
Article
Date
Apr-2014
Author
Aranka Anema
Thomas Kerr
M-J Milloy
Cindy Feng
Julio S G Montaner
Evan Wood
Author Affiliation
a British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , BC , Canada.
Source
AIDS Care. 2014 Apr;26(4):459-65
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active - methods
British Columbia
Canada
Cross-Sectional Studies
Drug users
Female
Food Supply
HIV Infections - blood - complications - drug therapy
Humans
Hunger
Logistic Models
Male
Medication Adherence
Middle Aged
Multivariate Analysis
Nutritional Status
Prospective Studies
RNA, Viral - blood - drug effects
Socioeconomic Factors
Substance Abuse, Intravenous - complications
Treatment Outcome
Abstract
Food insecurity may be a barrier to achieving optimal HIV treatment-related outcomes among illicit drug users. This study therefore, aimed to assess the impact of severe food insecurity, or hunger, on plasma HIV RNA suppression among illicit drug users receiving antiretroviral therapy (ART). A cross-sectional Multivariate logistic regression model was used to assess the potential relationship between hunger and plasma HIV RNA suppression. A sample of n = 406 adults was derived from a community-recruited open prospective cohort of HIV-positive illicit drug users, in Vancouver, British Columbia (BC), Canada. A total of 235 (63.7%) reported "being hungry and unable to afford enough food," and 241 (59.4%) had plasma HIV RNA
PubMed ID
24015838 View in PubMed
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