HIV-positive individuals in San Francisco who lack steady access to nutritious food are hospitalized and visit emergency rooms at a high rate, according to a study released Wednesday.
The study by UC San Francisco researchers, published online in the Journal of General Internal Medicine, focused on 347 HIV patients who are poor. Of those, 56 percent are considered to be food-insecure.
“Food security means someone is able to access good and healthy food at any time,” said Jean Cooper, director of programs for the Glide Foundation.
The population of HIV patients who are considered food insecure was about twice as likely to be hospitalized over the course of the two-year study.
Study co-author Sheri Weiser, who is an assistant professor of medicine in the UCSF HIV/AIDS Division at San Francisco General Hospital, told The San Francisco Examiner that the exact reasons behind the food insecurity and HIV health outcomes are not entirely clear, but other studies point to possible contributing factors.
The lack of proper nutrients may be a cause, Weiser said, along with the fact that low-income people might have to choose between buying food and their medications. She also noted a link between food insecurity and poor mental health, such as chronic anxiety and depression, and the strain it can take on a person’s health.
The study concluded that “addressing food insecurity should be a critical component of HIV treatment programs and may reduce reliance on acute care utilization.”
Adding food security to HIV care as part of a holistic approach could be difficult in San Francisco, though, because of the high cost of living.
“San Francisco is an expensive city, so a lot of our clients are always making decisions about how to spend their resources,” said Courtney Mulhern-Pearson, director of state and local affairs for the San Francisco AIDS Foundation.
The study also found that only one-tenth of participants received federal food assistance, and that increased enrollment could boost food security — a goal that also faces obstacles. The cutoff for assistance is $1,080 in monthly income, and people in San Francisco can exceed that income, pay for rent in a single-room occupancy home and yet have little left for food, according to Cooper of the Glide Foundation. Other aid, such as disability benefits, also can disqualify people from receiving food aid.
Those who live in SROs also may lack an adequate kitchen or food storage space, said Margot Kushel, the senior investigator for the study and an associate professor in the UCSF Division of Internal Medicine at San Francisco General.