Food Insecurity in HIV-Hepatitis C Virus Co-Infected Individuals in Canada: The Importance of Co-Morbidities

While research has begun addressing food insecurity (FI) in HIV-positive populations, knowledge regarding FI among individuals living with HIV-hepatitis C virus (HCV) co-infection is limited. 

This exploratory study examines sociodemographic, socioeconomic, behavioral, and clinical factors associated with FI in a cohort of HIV-HCV co-infected individuals in Canada. We analyzed longitudinal data from the Food Security and HIV-HCV Co-infection Study of the Canadian Co-infection Cohort collected between November 2012-June 2014 at 15 health centres. FI was measured using the Household Food Security Survey Module and classified using Health Canada criteria. Generalized estimating equations were used to assess factors associated with FI. 

Among 525 participants, 59 % experienced FI at their first study visit (baseline). Protective factors associated with FI (p < 0.05) included: enrolment at a Quebec study site, employment, and average personal monthly income. Risk factors for FI included: recent injection drug use, trading away food, and recent experiences of depressive symptoms. 

FI is common in this co-infected population. Engagement of co-infected individuals in substance use treatments, harm reduction programs, and mental health services may mitigate FI in this vulnerable subset of the HIV-positive population.

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By:  Cox J1,2,3, Hamelin AM4, McLinden T4, Moodie EE4, Anema A5,6, Rollet-Kurhajec KC7, Paradis G4, Rourke SB8,9,10, Walmsley SL11,12, Klein MB7; Canadian Co-infection Cohort Investigators.

• 1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada. joseph.cox@mcgill.ca.
• 2Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada. joseph.cox@mcgill.ca.
• 3CIHR Canadian HIV Trials Network, Vancouver, BC, Canada. joseph.cox@mcgill.ca.
• 4Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
• 5Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
• 6Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
• 7Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.
• 8Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
• 9The Ontario HIV Treatment Network, Toronto, ON, Canada.
• 10Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
• 11Department of Medicine, University of Toronto, Toronto, ON, Canada.
• 12Division of Infectious Diseases, University Health Network, Toronto, ON, Canada. 

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