Food Insecurity & Intimate Partner Violence Against Women: Results from the California Women's Health Survey

OBJECTIVE:

To investigate the association between food insecurity and intimate partner violence in a population-based sample of heterosexual women.

DESIGN:

Logistic regression was used to evaluate the association between three levels of food insecurity and intimate partner violence.

SETTING:

Data from 6 years of the California Women's Health Survey.

SUBJECTS:

Randomly selected women (n 16 562) aged 18 years and older from the State of California, USA.

RESULTS:

We found: 

1. that African-American women had a higher prevalence of food insecurity and were more likely to report severe intimate partner violence; 
2. a strong positive association between food insecurity and intimate partner violence; 
3. evidence of effect modification of the association between food insecurity and intimate partner violence by marital status; and 
4. higher odds of intimate partner violence among those reporting more severe food insecurity.

CONCLUSIONS:

Food insecurity is an important risk indicator for intimate partner violence among women. Understanding the factors that put women, especially minority women, at greatest risk facilitates intervention development.

Purchase full article at:   http://goo.gl/tihrXX

By:  Ricks JL1, Cochran SD1, Arah OA1, Williams JK2, Seeman TE1.

• 1Department of Epidemiology, Fielding School of Public Health, University of California,Los Angeles, CA, USA.
• 2Department of Psychiatry & Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA. 
• Public Health Nutr. 2016 Apr;19(5):914-23. doi: 10.1017/S1368980015001986. Epub 2015 Jun 22.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Growth in HIV-Infected Children on Long-Term Antiretroviral Therapy

OBJECTIVES:

To describe growth in HIV-infected children on long-term antiretroviral therapy (ART) and to assess social, clinical, immunological and virological factors associated with suboptimal growth.

METHODS:

This observational cohort study included all HIV-infected children at an urban ART site in South Africa who were younger than 5 years at ART initiation and with more than 5 years of follow-up. Growth was assessed using weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ) and body mass index (BMI)-for-age Z-scores (BAZ). Children were stratified according to pre-treatment anthropometry and age. Univariate and mixed linear analysis were used to determine associations between independent variables and weight and height outcomes.

RESULTS:

The majority of the 159 children presented with advanced clinical disease (90%) and immunosuppression (89%). Before treatment underweight, stunting and wasting were common (WAZ<-2= 50%, HAZ<-2= 73%, BAZ<-2= 19%). Weight and BMI improved during the initial 12 months, while height improved over the entire 5-year period. Height at study exit was significantly worse for children with growth impairment at ART initiation (p<0.001), although infants (<1 year) demonstrated superior improvement in terms of BMI (p=0.04). Tuberculosis was an independent risk factor for suboptimal weight (p=0.01) and height (p=0.02) improvement. Weight gain was also hindered by lack of electricity (p=0.04). Immune reconstitution and virological suppression were not associated with being underweight or stunted at study end point.

CONCLUSIONS:

Malnutrition was a major clinical concern for this cohort of HIV-infected children. Early ART initiation, tuberculosis co-infection management and nutritional interventions are crucial to ensure optimal growth in HIV-infected children. This article is protected by copyright. All rights reserved.

Purchase full article at:   http://goo.gl/7Q9Bjf

By:  Feucht UD¹, van Bruwaene L^1,2, Becker PJ³, Kruger M⁴.

¹Department of Paediatrics, Kalafong hospital, University of Pretoria, Pretoria, South Africa.

²University Hospital Gasthuisberg, Leuven, Belgium.

³Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.

⁴Department of Paediatrics and Child Health, University of Stellenbosch, Tygerberg, South Africa.

Trop Med Int Health. 2016 Feb 23. doi: 10.1111/tmi.12685.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Integration of HIV Care into Community Management of Acute Childhood Malnutrition Permits Good Outcomes: Lusaka, Zambia

Background

While HIV has had a major impact on health care in southern Africa, there are few data on its impact on acute malnutrition in children in the community. We report an analysis of outcomes in a large programme of community management of acute malnutrition in the south of Lusaka.

Programme Activities and Analysis

Over 3 years, 68,707 assessments for undernutrition were conducted house-to-house, and children with severe acute malnutrition (SAM) or moderate acute malnutrition (MAM) were enrolled into either Outpatient Therapeutic Programme (OTP) or Supplementary Feeding Programme (SFP) respectively. Case records were analysed using tabulation and unconditional logistic regression.

Findings

1,859 children (889 boys, 970 girls; median age 16 months) with MAM (n = 664) or SAM (n = 1,195) were identified. Of 1,796 children whose parents consented to testing, 185 (10.3%) were HIV positive. Altogether 1,163 (62.6%) were discharged as recovered from acute malnutrition. Case fatality while in the programme was 4.2% in children with SAM and 0.5% in those with MAM, and higher in children with HIV infection. In multivariate analysis, HIV, MUAC <11.5cm and the first year of the program all increased mortality. Children with HIV infection who were able to initiate antiretroviral therapy had lower mortality.

Interpretation

Our programme suggests that a comprehensive community malnutrition programme, incorporating HIV care, can achieve low mortality even in a population heavily affected by HIV.

Below:  Flow of children with MAM through the program

Full article at:   http://goo.gl/N84AKd

By:  

Beatrice Amadi, Mercy Imikendu, Milika Sakala, Rosemary Banda 
Department of Paediatrics, University Teaching Hospital, Nationalist Road, Lusaka, Zambia

Beatrice Amadi, Paul Kelly 

Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia

Paul Kelly 

Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, 4 Newark Street, London, United Kingdom

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

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.

Purchase full article at:   http://goo.gl/d20K1v

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. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Undernutrition and Anaemia among HAART-Naïve HIV Infected Children in Lle-Lfe, Nigeria

More at ht.ly/Ppyi8 HT @PANAFRMEDJ 

Results: The prevalence of stunting, underweight and wasting among the HIV infected subjects were 48. 6%,58. 6% and 31. 4% respectively which as significantly higher than 28. 1%, 7. 1% and 28. 1% among the HIV negative controls. 20. 1% of the HIV infected children were marasmic compared to 2. 3% of the controls . Triple anthropometric failure was found in 7. 1% of the subjects as compared to none among the controls. Anaemia is significantly more prevalent among the subjects than the controls (70. 0% vs 31. 4%; p<0. 001). The prevalence of anaemia was higher in the HIV infected subjects with undernutrition. Low socioeconomic status, hypoalbuminemia and severe immunosuppression are significantly associated with higher undernutrition prevalence.

Conclusion: Several years after availability of HAART, undernutrition and anaemia remain widely prevalent among newly presenting HAART naïve HIV infected Nigerian children . Nutritional supplementation and evaluation for anaemia still need close attention in the management of these children.

Below:  Prevalence of mild-moderate and severe anaemia in the HIV infected subjects and HIV negative controls