TY - JOUR
T1 - Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States
AU - Tuthill, Emily L.
AU - Sheira, Lila A.
AU - Palar, Kartika
AU - Frongillo, Edward A.
AU - Wilson, Tracey E.
AU - Adedimeji, Adebola
AU - Merenstein, Daniel
AU - Cohen, Mardge H.
AU - Wentz, Eryka L.
AU - Adimora, Adaora A.
AU - Ofotokun, Ighovwerha
AU - Metsch, Lisa
AU - Kushel, Margot
AU - Turan, Janet M.
AU - Konkle-Parker, Deborah
AU - Tien, Phyllis C.
AU - Weiser, Sheri D.
N1 - Publisher Copyright:
© 2019 American Society for Nutrition. All rights reserved.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Food insecurity and mental health negatively affect the lives of women in the United States. Participants in theWomen's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time. Objective: We investigated the association between current and persistent food insecurity and depression among women at risk of or living with HIV in the United States. Methods: We used longitudinal data from the WIHS, a prospective cohort study in women at risk of or living with HIV from multiple sites in the United States. Participants completed 6 semiannual assessments from 2013 to 2016 on food security (FS; high, marginal, low, and very low) and mental health (i.e., depressive symptoms and mental well-being). We used multiple regression analysis to estimate the association between these variables. Results: Among 2551 participants, 44% were food insecure and 35% reported depressive symptoms indicative of probable depression. Current marginal, low, and very low FS were associated with 2.1-, 3.5-, and 5.5-point (all P < 0.001) higher depression scores, respectively. In models adjusting for both current and previous FS, previous marginal, low, and very low FS were associated with 0.2-, 0.93-, and 1.52-point higher scores, respectively (all P < 0.001). Women with very low FS at both time points (persistent food insecurity) had a 6.86-point higher depression score (P < 0.001). In the mental health models, there was a dose-response relation between current FS and worse mental health even when controlling for previous FS (all P < 0.001). Previous low FS was associated with worse mental health. These associations did not differ by HIV status. Conclusions: Food insecurity placed women at risk of depression and poor mental well-being, but the risk was substantially higher for women experiencing persistent food insecurity. Future interventions to improve women'smental health call for multilevel components that include addressing food insecurity. J Nutr 2019;149:240-248.
AB - Food insecurity and mental health negatively affect the lives of women in the United States. Participants in theWomen's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time. Objective: We investigated the association between current and persistent food insecurity and depression among women at risk of or living with HIV in the United States. Methods: We used longitudinal data from the WIHS, a prospective cohort study in women at risk of or living with HIV from multiple sites in the United States. Participants completed 6 semiannual assessments from 2013 to 2016 on food security (FS; high, marginal, low, and very low) and mental health (i.e., depressive symptoms and mental well-being). We used multiple regression analysis to estimate the association between these variables. Results: Among 2551 participants, 44% were food insecure and 35% reported depressive symptoms indicative of probable depression. Current marginal, low, and very low FS were associated with 2.1-, 3.5-, and 5.5-point (all P < 0.001) higher depression scores, respectively. In models adjusting for both current and previous FS, previous marginal, low, and very low FS were associated with 0.2-, 0.93-, and 1.52-point higher scores, respectively (all P < 0.001). Women with very low FS at both time points (persistent food insecurity) had a 6.86-point higher depression score (P < 0.001). In the mental health models, there was a dose-response relation between current FS and worse mental health even when controlling for previous FS (all P < 0.001). Previous low FS was associated with worse mental health. These associations did not differ by HIV status. Conclusions: Food insecurity placed women at risk of depression and poor mental well-being, but the risk was substantially higher for women experiencing persistent food insecurity. Future interventions to improve women'smental health call for multilevel components that include addressing food insecurity. J Nutr 2019;149:240-248.
KW - HIV
KW - United States
KW - food insecurity
KW - mental health
KW - women
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UR - http://www.scopus.com/inward/citedby.url?scp=85062273365&partnerID=8YFLogxK
U2 - 10.1093/jn/nxy203
DO - 10.1093/jn/nxy203
M3 - Article
C2 - 30753638
AN - SCOPUS:85062273365
SN - 0022-3166
VL - 149
SP - 240
EP - 248
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 2
ER -