B. Idrisov1, K. Lunze2, D.M. Cheng2, E. Blokhina3, N. Gnatienko2, G. Patts2, A. Tyurina3, C. Bridden2, C. Chaisson2, M.J. Larson4, E. Krupitsky3, J.H. Samet2. 1Bashkir State Medical University, Russia; 2Boston University, United States; 3First St. Petersburg Pavlov State Medical University, Russia; 4Brandeis University, United States
Background: Food insecurity (FI), the limited availability or inadequate procurement of nutritionally sufficient food, has been shown to be associated with HIV transmission, with few studies in drug-using populations. We hypothesized that FI is associated with HIV risk behaviors among Russians living with HIV, many with recent substance use.
Methods: We analyzed baseline data from the Russia ARCH Cohort, a study of ART-naive people living with HIV (n=264) to assess the association between FI and HIV transmission risk. Primary outcomes were recent needle sharing and number of unprotected sexual contacts (USC). The Household Food Insecurity Access Scale was used to assess FI (any vs. none). Analyses used negative binomial and logistic regression models.
Results: FI was common in this cohort 146 (55%) with 96 (36%) current injection drug and 163 (62%) recent heavy alcohol users. Risk behavior characteristics were as follows: 26 (10%) reported 30-day needle sharing, and mean number of past 90-day USC was 15 (interquartile range 0-17). In analyses adjusted for age, gender, BMI, and employment, FI was associated with needle sharing (OR=4.10; p=0.02). There was no significant association between FI and number of USC (IRR=0.79; p=0.46) in analyses controlling for demographics, substance use, and number of sex partners.
Conclusion: Food insecurity occurred in a majority of HIV-infected Russians and was significantly associated with needle sharing but not sex risk. In a drug-related HIV epidemic, establishing and maintaining food security among key populations may be important to achieve effective HIV prevention and reduce drug risk behaviors. Supported by: U01AA020780;U24AA020779.