Chen Cheng, Yang Xueying, Zeng Chengbo, Li Xiaoming, Qiao Shan, Zhou Yuejiao
School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200025, China.
Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC, USA.
Health Psychol Behav Med. 2020;8(1):636-648. doi: 10.1080/21642850.2020.1854762. Epub 2020 Dec 8.
Previous studies showed that food insecurity could adversely affect clinical outcomes of people living with HIV (PLWH). The mental health pathways of such effects are suggested in existing literature, but empirical data are limited in resource-limited settings.
This cross-sectional study aims to explore the role of depressive symptoms and anxiety on the association between food insecurity and CD4 counts among a sample of 2,987 PLWH in Guangxi, China. Path analysis was used to examine a hypothetical model and delta z test was used to assess the indirect effects of food insecurity on CD4 counts through depressive symptoms and anxiety.
The prevalence of food insecurity in this sample was 25.3%, and the median CD4 counts was 318 cells/mm. In correlation analyses, food insecurity was not directly associated with LogCD4 but was associated with depressive symptoms and anxiety. Path analysis indicated a significant indirect effect from food insecurity to LogCD4 through depressive symptoms, but not anxiety.
Improving mental health among PLWH with food insecurity may be beneficial for treatment outcomes. Besides intervening food insecurity, an intervention targeting depressive symptoms could improve the immunologic outcomes of PLWH.
先前的研究表明，粮食不安全可能会对艾滋病毒感染者（PLWH）的临床结局产生不利影响。现有文献中提出了这种影响的心理健康途径，但在资源有限的环境中，实证数据有限。
这项横断面研究旨在探讨抑郁症状和焦虑在广西2987名PLWH样本中粮食不安全与CD4细胞计数之间关联中的作用。采用路径分析来检验一个假设模型，并使用delta z检验来评估粮食不安全通过抑郁症状和焦虑对CD4细胞计数的间接影响。
该样本中粮食不安全的患病率为25.3%，CD4细胞计数中位数为318个细胞/立方毫米。在相关性分析中，粮食不安全与LogCD4没有直接关联，但与抑郁症状和焦虑有关。路径分析表明，粮食不安全通过抑郁症状对LogCD4有显著的间接影响，但通过焦虑没有。
改善粮食不安全的PLWH的心理健康可能有利于治疗结果。除了干预粮食不安全外，针对抑郁症状的干预措施可以改善PLWH的免疫结局。
