Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya

Mira Wang; Joshua D. Miller; Shalean M. Collins; Marianne V. Santoso; Pauline Wekesa; Hideaki Okochi; Maricianah Onono; Sheri Weiser; Monica Gandhi; Sera L. Young

doi:10.1007/s10461-020-02839-9

Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya

Mira Wang, Joshua D. Miller, Shalean M. Collins, Marianne V. Santoso, Pauline Wekesa, Hideaki Okochi, Maricianah Onono, Sheri Weiser, Monica Gandhi, Sera L. Young^*

^*Corresponding author for this work

Anthropology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Food insecurity (FI), low social support, and low health-related quality of life (HRQoL) are associated with self-reported nonadherence to antiretroviral therapy (ART) among postpartum women, but these relationships have not been evaluated using objective adherence indicators. Hair samples were therefore analyzed among 83 postpartum Kenyan women living with HIV on efavirenz and nevirapine ART drug regimens in an observational cohort (NCT02974972). FI (0–27), social support (0–40), and HRQoL (8–40) in the prior month were also assessed. In multivariable models, each point increase in FI and decrease in HRQoL were associated with a 45.1% (95% CI: −64.3%, −15.6%) and 10.5% decrease (95% CI: 1.0%, 22.1%) in hair ART drug concentrations respectively, when social support was held constant. A significant interaction between social support and FI (β = 0.02, p = 0.017) indicated that greater social support was predicted to mitigate the negative impacts of FI on ART adherence. Addressing these modifiable barriers could improve ART adherence during this critical period.

Original language	English (US)
Pages (from-to)	2885-2894
Number of pages	10
Journal	AIDS and behavior
Volume	24
Issue number	10
DOIs	https://doi.org/10.1007/s10461-020-02839-9
State	Published - Oct 1 2020

Keywords

Antiretroviral adherence
Food insecurity
Hair ART drug concentrations
Postpartum
Social support

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10461-020-02839-9

Cite this

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title = "Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya",

abstract = "Food insecurity (FI), low social support, and low health-related quality of life (HRQoL) are associated with self-reported nonadherence to antiretroviral therapy (ART) among postpartum women, but these relationships have not been evaluated using objective adherence indicators. Hair samples were therefore analyzed among 83 postpartum Kenyan women living with HIV on efavirenz and nevirapine ART drug regimens in an observational cohort (NCT02974972). FI (0–27), social support (0–40), and HRQoL (8–40) in the prior month were also assessed. In multivariable models, each point increase in FI and decrease in HRQoL were associated with a 45.1% (95% CI: −64.3%, −15.6%) and 10.5% decrease (95% CI: 1.0%, 22.1%) in hair ART drug concentrations respectively, when social support was held constant. A significant interaction between social support and FI (β = 0.02, p = 0.017) indicated that greater social support was predicted to mitigate the negative impacts of FI on ART adherence. Addressing these modifiable barriers could improve ART adherence during this critical period.",

keywords = "Antiretroviral adherence, Food insecurity, Hair ART drug concentrations, Postpartum, Social support",

author = "Mira Wang and Miller, {Joshua D.} and Collins, {Shalean M.} and Santoso, {Marianne V.} and Pauline Wekesa and Hideaki Okochi and Maricianah Onono and Sheri Weiser and Monica Gandhi and Young, {Sera L.}",

note = "Funding Information: We thank the Kenya Medical Research Institute (KEMRI) for providing space within the FACES clinics for the work to be conducted, logistic support to conduct this research, and oversight in Kenya. We would also like to warmly thank study nurses and study trackers, as well as the mothers and their infants who participated in this study. Further, we thank the anonymous reviewers in the peer review process, whose comments significantly improved our analyses. The study (NCT02974972) was supported by the National Institute of Mental Health (NIH/NIMH K01 MH098902) and the National Institute of Allergy and Infectious Diseases (NIAID 2RO1AI098472). Funding Information: We thank the Kenya Medical Research Institute (KEMRI) for providing space within the FACES clinics for the work to be conducted, logistic support to conduct this research, and oversight in Kenya. We would also like to warmly thank study nurses and study trackers, as well as the mothers and their infants who participated in this study. Further, we thank the anonymous reviewers in the peer review process, whose comments significantly improved our analyses. The study (NCT02974972) was supported by the National Institute of Mental Health (NIH/NIMH K01 MH098902) and the National Institute of Allergy and Infectious Diseases (NIAID 2RO1AI098472). Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

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doi = "10.1007/s10461-020-02839-9",

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AU - Wang, Mira

AU - Miller, Joshua D.

AU - Collins, Shalean M.

AU - Santoso, Marianne V.

AU - Wekesa, Pauline

AU - Okochi, Hideaki

AU - Onono, Maricianah

AU - Weiser, Sheri

AU - Gandhi, Monica

AU - Young, Sera L.

N1 - Funding Information: We thank the Kenya Medical Research Institute (KEMRI) for providing space within the FACES clinics for the work to be conducted, logistic support to conduct this research, and oversight in Kenya. We would also like to warmly thank study nurses and study trackers, as well as the mothers and their infants who participated in this study. Further, we thank the anonymous reviewers in the peer review process, whose comments significantly improved our analyses. The study (NCT02974972) was supported by the National Institute of Mental Health (NIH/NIMH K01 MH098902) and the National Institute of Allergy and Infectious Diseases (NIAID 2RO1AI098472). Funding Information: We thank the Kenya Medical Research Institute (KEMRI) for providing space within the FACES clinics for the work to be conducted, logistic support to conduct this research, and oversight in Kenya. We would also like to warmly thank study nurses and study trackers, as well as the mothers and their infants who participated in this study. Further, we thank the anonymous reviewers in the peer review process, whose comments significantly improved our analyses. The study (NCT02974972) was supported by the National Institute of Mental Health (NIH/NIMH K01 MH098902) and the National Institute of Allergy and Infectious Diseases (NIAID 2RO1AI098472). Publisher Copyright: © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

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N2 - Food insecurity (FI), low social support, and low health-related quality of life (HRQoL) are associated with self-reported nonadherence to antiretroviral therapy (ART) among postpartum women, but these relationships have not been evaluated using objective adherence indicators. Hair samples were therefore analyzed among 83 postpartum Kenyan women living with HIV on efavirenz and nevirapine ART drug regimens in an observational cohort (NCT02974972). FI (0–27), social support (0–40), and HRQoL (8–40) in the prior month were also assessed. In multivariable models, each point increase in FI and decrease in HRQoL were associated with a 45.1% (95% CI: −64.3%, −15.6%) and 10.5% decrease (95% CI: 1.0%, 22.1%) in hair ART drug concentrations respectively, when social support was held constant. A significant interaction between social support and FI (β = 0.02, p = 0.017) indicated that greater social support was predicted to mitigate the negative impacts of FI on ART adherence. Addressing these modifiable barriers could improve ART adherence during this critical period.

AB - Food insecurity (FI), low social support, and low health-related quality of life (HRQoL) are associated with self-reported nonadherence to antiretroviral therapy (ART) among postpartum women, but these relationships have not been evaluated using objective adherence indicators. Hair samples were therefore analyzed among 83 postpartum Kenyan women living with HIV on efavirenz and nevirapine ART drug regimens in an observational cohort (NCT02974972). FI (0–27), social support (0–40), and HRQoL (8–40) in the prior month were also assessed. In multivariable models, each point increase in FI and decrease in HRQoL were associated with a 45.1% (95% CI: −64.3%, −15.6%) and 10.5% decrease (95% CI: 1.0%, 22.1%) in hair ART drug concentrations respectively, when social support was held constant. A significant interaction between social support and FI (β = 0.02, p = 0.017) indicated that greater social support was predicted to mitigate the negative impacts of FI on ART adherence. Addressing these modifiable barriers could improve ART adherence during this critical period.

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Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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