The role of mental health on the relationship between food insecurity and immunologic outcome among people living with HIV in Guangxi, China.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.