Material-need insecurities, i.e., insufficient or unacceptable food, housing, healthcare, and/or finances, are common among low-income individuals, and contribute to worse health outcomes. In this renewal application, we plan to extend the work from our previous food insecurity study that was conducted in the Women’s Interagency HIV Study (WIHS) and propose to investigate the intersectional effects of four different types of insecurity related to basic material needs (food, housing, financial, and healthcare) on HIV and CVD outcomes among both men and women. Material-need insecurities include absolute insufficiency of resources (hunger, homelessness, inadequate finances, no health insurance), poor quality of resources (diets, housing, financial means, healthcare coverage), uncertainty of consistently meeting needs in the future, and having to engage in socially unacceptable means to meet needs. This proposal addresses an important gap in the literature since no studies have comprehensively investigated the intersection of different material-need insecurities among HIV-affected communitiesincluding how different insecurities may co-occur, among which populations, how they may or may not combine to affect synergistically HIV and CVD outcomes, and the relative importance of different mediating mechanisms for different outcomes. Understanding intersectional effects can inform interventions that target more than one need simultaneously. We have assembled a multidisciplinary team with expertise in HIV medicine, cardiology and cardiovascular imaging social-behavioral science, and biostatistics to accomplish three specific aims: Aim 1: To determine the separate as well as intersectional effects (using latent profile analysis) of four specific material-need insecurities (food, housing, financial and healthcare insecurity) on HIV and CVD outcomes. Aim 2: To determine the intermediate outcomes that may be on causal paths between material-need insecurities and HIV and CVD risk indicators using convergent parallel mixed methods. Aim 3: To determine factors that moderate impacts of material-need insecurities on HIV and CVD outcomes using a convergent parallel design.
|Effective start/end date||8/4/20 → 6/30/24|
- University of California, San Francisco (12480sc-Amnd 01//5R01HL155226-02)
- National Heart, Lung, and Blood Institute (12480sc-Amnd 01//5R01HL155226-02)
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