Household food insecurity and anti retro viral adherence among adult HIV positive patients attending care and treatment clinics in Temeke, Dar es Salaam

Abstract

Background: Among those persons taking ARV therapies, more than half were food insecure, and food insecurity was associated with incomplete adherence and viral non-suppression in people who were less than 80% adherent .Main objective: To assess the magnitude of household food insecurity and its determinants, its association to adherence to ART among adult patients attending CTCs in Dar es salaam. Methodology: A descriptive cross sectional facility-based study, conducted in Feb 2012.Simple random sampling was done daily to select participants from the registry. Data was collected through face-to- face structured interviews using a structured questionnaire. Adherence was assessed by self report in the last month before the study and Household Food Insecurity Access Scale tool was used to access food insecurity. Subjects: A total of 272 HIV/AIDS patients aged 18years and above attending CTCs in Dar es Salaam who have been on ART were selected. Results: A total of 272 (females=67.9%; males= 32.1%) people living with HIV/AIDS attending CTC were interviewed. The average age of the respondents was 38 years old and most (43.9%)() were married. The majority (65.1%) respondents had primary school education. However, food insecurity was least (48.2%) among those who were single and highest (57.7%) among those widowed. Low level of food insecurity was associated with having completed secondary education (Adjusted OR=0.75; 95%CI, 0.047–1.19) and high household size with adults who are employed (OR=0.54; 95%CI, 0.34–0.85). Participants who lived as singles were less associated food security or less meals increased the likelihood of food insecurity (OR=4.2; 95% CI1.7-9.8). Low frequency of meals was significantly more prevalent (18.6%) multiple logistic regression to determine socio-demographic and factors associated with food insecurity which was measured using the Household Food Insecurity Access Scale. The study showed that approximately 42% of the households were categorized as food secure, 9.6% as mildly food-insecure, 32.9% as moderately food-insecure and 13.2% as severely food-insecure. Food insecurity was positively associated with the number of members in the household (P<0.05) and negatively associated with parental education level and job status and ART adherence (P<0.05). CONCLUSIONS AND RECOMMENDATIONS: Food insecurity was prevalent among households in HIV patients in Temeke district and food insecurity status was associated with socio-economic factors. Screening for and v addressing food insecurity should be a critical component of HIV prevention and treatment programs. Household food insecurity should be assessed in a larger and more diverse population in urban setting.