Background:

The dual epidemics of food insecurity and HIV/AIDS are a growing concern in South Africa. Rates of undernourishment are increasing among people living with HIV (PLWH). We wanted to explore the association between food insecurity and trust in providers among adolescents and young adults (AYA) living with HIV.

Methods:

We analyzed baseline data from Standing Tall, a prospective cohort study of newly diagnosed HIV-positive AYA in South Africa from 2018 – 2019. We performed a cross-sectional analysis of food insecurity, defined using the Household Food Insecurity Access Survey (HFIAS).

Results:

Overall, 100 subjects were included in the analysis. The mean age was 21 years old. At baseline, the prevalence of food insecurity was 63%. In adjusted analyses, the odds of complete trust in the healthcare system were significantly lower in those with more food insecurity than those with less food insecurity (aOR: 0.28, 95% CI: 0.09, 0.97). The adjusted odds ratio for complete trust in providers was similar (aOR: 0.45, 95% CI: 0.15, 1.39).

Conclusion:

The majority of AYA diagnosed with HIV report high levels of food insecurity that are associated with lower trust in the healthcare system. Every health encounter with young PLWH should incorporate screening for food insecurity to increase early identification and referral to appropriate resources.