Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States

Henry J. Whittle, Lila A. Sheira, Edward A. Frongillo, Kartika Palar, Jennifer Cohen, Daniel Merenstein, Tracey E. Wilson, Adebola A. Adedimeji, Mardge H. Cohen, Adaora A. Adimora, Ighovwerha Ofotokun, Lisa Metsch, Janet M. Turan, Eryka L. Wentz, Phyllis C. Tien, Sheri D. Weiser

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background and Aims: Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. Design: Women's Interagency HIV Study (WIHS), a prospective cohort study. Setting: Nine sites across the United States. Participants: A total of 2553 women with or at risk for HIV. Measurements: Semi-annual structured interviews were conducted during April 2013–March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of current and previous FS with the outcomes simultaneously, adjusting for socio-demographic factors, HIV serostatus, physical health and health insurance. Findings: Average number of visits was 4.6. At baseline, 71% of participants were HIV-seropositive, 44% reported marginal, low, or very low FS, and 13% were using illicit substances. In adjusted analyses, current low and very low FS were significantly associated with 1.59 [95% confidence interval (CI) = 1.02, 2.46; P = 0.039] and 2.48 (95% CI = 1.52, 4.04; P < 0.001) higher odds of any illicit substance use, compared to high FS, and also with higher odds of cannabis, stimulant and opioid use, exhibiting a consistent dose–response relationship. Marginal, low, and very low FS at the previous visit were associated with 1.66 (95% CI = 1.08, 2.54; P = 0.020), 1.77 (95% CI = 1.14, 2.74; P = 0.011), and 2.28 (95% CI = 1.43, 3.64; P < 0.001) higher odds of current illicit substance use. Conclusions: Food insecurity appears to be longitudinally associated with substance use among US women with or at risk for HIV.

Original languageEnglish (US)
JournalAddiction
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Food Supply
HIV
Confidence Intervals
Cannabis
Opioid Analgesics
Prescription Drug Misuse
Crack Cocaine
Amphetamines
Drug Prescriptions
Methamphetamine
Methadone
Narcotics
Heroin
Health Insurance
Longitudinal Studies
Cohort Studies
Logistic Models
Demography
Prospective Studies
Interviews

Keywords

  • Drug use
  • food insecurity
  • HIV
  • mental health
  • substance use
  • women

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Whittle, H. J., Sheira, L. A., Frongillo, E. A., Palar, K., Cohen, J., Merenstein, D., ... Weiser, S. D. (Accepted/In press). Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States. Addiction. https://doi.org/10.1111/add.14418

Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States. / Whittle, Henry J.; Sheira, Lila A.; Frongillo, Edward A.; Palar, Kartika; Cohen, Jennifer; Merenstein, Daniel; Wilson, Tracey E.; Adedimeji, Adebola A.; Cohen, Mardge H.; Adimora, Adaora A.; Ofotokun, Ighovwerha; Metsch, Lisa; Turan, Janet M.; Wentz, Eryka L.; Tien, Phyllis C.; Weiser, Sheri D.

In: Addiction, 01.01.2018.

Research output: Contribution to journalArticle

Whittle, HJ, Sheira, LA, Frongillo, EA, Palar, K, Cohen, J, Merenstein, D, Wilson, TE, Adedimeji, AA, Cohen, MH, Adimora, AA, Ofotokun, I, Metsch, L, Turan, JM, Wentz, EL, Tien, PC & Weiser, SD 2018, 'Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States', Addiction. https://doi.org/10.1111/add.14418
Whittle, Henry J. ; Sheira, Lila A. ; Frongillo, Edward A. ; Palar, Kartika ; Cohen, Jennifer ; Merenstein, Daniel ; Wilson, Tracey E. ; Adedimeji, Adebola A. ; Cohen, Mardge H. ; Adimora, Adaora A. ; Ofotokun, Ighovwerha ; Metsch, Lisa ; Turan, Janet M. ; Wentz, Eryka L. ; Tien, Phyllis C. ; Weiser, Sheri D. / Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States. In: Addiction. 2018.
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abstract = "Background and Aims: Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. Design: Women's Interagency HIV Study (WIHS), a prospective cohort study. Setting: Nine sites across the United States. Participants: A total of 2553 women with or at risk for HIV. Measurements: Semi-annual structured interviews were conducted during April 2013–March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of current and previous FS with the outcomes simultaneously, adjusting for socio-demographic factors, HIV serostatus, physical health and health insurance. Findings: Average number of visits was 4.6. At baseline, 71{\%} of participants were HIV-seropositive, 44{\%} reported marginal, low, or very low FS, and 13{\%} were using illicit substances. In adjusted analyses, current low and very low FS were significantly associated with 1.59 [95{\%} confidence interval (CI) = 1.02, 2.46; P = 0.039] and 2.48 (95{\%} CI = 1.52, 4.04; P < 0.001) higher odds of any illicit substance use, compared to high FS, and also with higher odds of cannabis, stimulant and opioid use, exhibiting a consistent dose–response relationship. Marginal, low, and very low FS at the previous visit were associated with 1.66 (95{\%} CI = 1.08, 2.54; P = 0.020), 1.77 (95{\%} CI = 1.14, 2.74; P = 0.011), and 2.28 (95{\%} CI = 1.43, 3.64; P < 0.001) higher odds of current illicit substance use. Conclusions: Food insecurity appears to be longitudinally associated with substance use among US women with or at risk for HIV.",
keywords = "Drug use, food insecurity, HIV, mental health, substance use, women",
author = "Whittle, {Henry J.} and Sheira, {Lila A.} and Frongillo, {Edward A.} and Kartika Palar and Jennifer Cohen and Daniel Merenstein and Wilson, {Tracey E.} and Adedimeji, {Adebola A.} and Cohen, {Mardge H.} and Adimora, {Adaora A.} and Ighovwerha Ofotokun and Lisa Metsch and Turan, {Janet M.} and Wentz, {Eryka L.} and Tien, {Phyllis C.} and Weiser, {Sheri D.}",
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TY - JOUR

T1 - Longitudinal associations between food insecurity and substance use in a cohort of women with or at risk for HIV in the United States

AU - Whittle, Henry J.

AU - Sheira, Lila A.

AU - Frongillo, Edward A.

AU - Palar, Kartika

AU - Cohen, Jennifer

AU - Merenstein, Daniel

AU - Wilson, Tracey E.

AU - Adedimeji, Adebola A.

AU - Cohen, Mardge H.

AU - Adimora, Adaora A.

AU - Ofotokun, Ighovwerha

AU - Metsch, Lisa

AU - Turan, Janet M.

AU - Wentz, Eryka L.

AU - Tien, Phyllis C.

AU - Weiser, Sheri D.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Aims: Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. Design: Women's Interagency HIV Study (WIHS), a prospective cohort study. Setting: Nine sites across the United States. Participants: A total of 2553 women with or at risk for HIV. Measurements: Semi-annual structured interviews were conducted during April 2013–March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of current and previous FS with the outcomes simultaneously, adjusting for socio-demographic factors, HIV serostatus, physical health and health insurance. Findings: Average number of visits was 4.6. At baseline, 71% of participants were HIV-seropositive, 44% reported marginal, low, or very low FS, and 13% were using illicit substances. In adjusted analyses, current low and very low FS were significantly associated with 1.59 [95% confidence interval (CI) = 1.02, 2.46; P = 0.039] and 2.48 (95% CI = 1.52, 4.04; P < 0.001) higher odds of any illicit substance use, compared to high FS, and also with higher odds of cannabis, stimulant and opioid use, exhibiting a consistent dose–response relationship. Marginal, low, and very low FS at the previous visit were associated with 1.66 (95% CI = 1.08, 2.54; P = 0.020), 1.77 (95% CI = 1.14, 2.74; P = 0.011), and 2.28 (95% CI = 1.43, 3.64; P < 0.001) higher odds of current illicit substance use. Conclusions: Food insecurity appears to be longitudinally associated with substance use among US women with or at risk for HIV.

AB - Background and Aims: Few longitudinal studies have examined the relationship between food insecurity and substance use. We aimed to investigate this relationship using longitudinal data among women with or at risk for HIV in the United States. Design: Women's Interagency HIV Study (WIHS), a prospective cohort study. Setting: Nine sites across the United States. Participants: A total of 2553 women with or at risk for HIV. Measurements: Semi-annual structured interviews were conducted during April 2013–March 2016. Food security (FS) was the primary predictor, measured using the Household Food Security Survey Module. Outcomes were: any illicit substance use except cannabis; licit or illicit cannabis use; stimulant use (crack, cocaine, or methamphetamine); opioid use (heroin or methadone in a non-prescribed way); and prescription drug misuse (prescription narcotics, amphetamines, or tranquilizers in a non-prescribed way) since the last visit. We used multivariable logistic regression with random effects to examine longitudinal associations of current and previous FS with the outcomes simultaneously, adjusting for socio-demographic factors, HIV serostatus, physical health and health insurance. Findings: Average number of visits was 4.6. At baseline, 71% of participants were HIV-seropositive, 44% reported marginal, low, or very low FS, and 13% were using illicit substances. In adjusted analyses, current low and very low FS were significantly associated with 1.59 [95% confidence interval (CI) = 1.02, 2.46; P = 0.039] and 2.48 (95% CI = 1.52, 4.04; P < 0.001) higher odds of any illicit substance use, compared to high FS, and also with higher odds of cannabis, stimulant and opioid use, exhibiting a consistent dose–response relationship. Marginal, low, and very low FS at the previous visit were associated with 1.66 (95% CI = 1.08, 2.54; P = 0.020), 1.77 (95% CI = 1.14, 2.74; P = 0.011), and 2.28 (95% CI = 1.43, 3.64; P < 0.001) higher odds of current illicit substance use. Conclusions: Food insecurity appears to be longitudinally associated with substance use among US women with or at risk for HIV.

KW - Drug use

KW - food insecurity

KW - HIV

KW - mental health

KW - substance use

KW - women

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DO - 10.1111/add.14418

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