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Mannette J, Zhang Y, Rothfus M, Purdy C, Tesfatsion W, Lynch M, Hamilton-Hinch B, Williams PL, Joy P, Grant S. Exploring current nutritional programming and resources available to people living with HIV in Canada: a scoping review. JBI Evid Synth 2023; 21:2022-2081. [PMID: 37194312 PMCID: PMC10566589 DOI: 10.11124/jbies-22-00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE The objective of this scoping review was to map the current literature and resources available on nutrition and food programming for people living with HIV in Canada. This review is phase 1 of a 4-phase project, called FoodNOW (Food to eNhance Our Wellness), a community-based nutritional needs assessment of people living with HIV in Nova Scotia, Canada. INTRODUCTION People living with HIV may experience nutritional challenges, including nutritional deficiencies associated with the virus, food insecurity, and nutrition-drug interactions. Nutritional programming is often required for optimal care for people living with HIV. The literature, however, has not been sufficiently mapped to create a comprehensive picture of available programming. This review has informed the development of subsequent study phases, and will contribute towards shaping and planning food programs, as well as evaluating the need for subsequent systematic reviews. INCLUSION CRITERIA This review considered literature focused on nutrition and food programming and resources in Canada for people living with HIV. People living with HIV of any age, sex, race, gender identity, or sexual orientation, as well as pregnant and lactating people, were included as the population of interest. METHODS The databases searched were MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premier (EBSCO), Social Services Abstracts (ProQuest), and Scopus. Sources of gray literature searched included government and organization websites, and Google searches. The database search was conducted in July 2021, and the gray literature searches were conducted in August and October 2021. Searches were limited to evidence published or translated in English. Two independent reviewers conducted title and abstract screening, and potentially relevant results were retrieved in full. Full-text screening and data extraction was conducted by 2 independent reviewers using a data extraction tool designed specifically for the scoping review objectives and research inclusion criteria, and any conflicts were resolved through discussion. Results are presented in both tabular and diagrammatic formats, with a narrative summary. RESULTS A total of 581 results were screened (published and gray literature). A total of 64 results were included in the review. The 6 reasons for exclusion at full-text review were i) not nutrition and food programming (n= 83), ii) not Canadian (n= 37), iii) duplicates (n= 22), iv) not focused on people living with HIV (n= 6), v) conference abstract (n= 1), and vi) not in English (n= 1). A total of 76 resources were located, as some of the 64 included sources offered more than 1 resource. The 76 resources were organized into 6 categories: i) charitable food provision (n = 21; 27.6%), ii) financial aid (n = 14; 18.4%), iii) nutrition care (n =12; 15.8%), iv) providing access to secondary sources (n= 10; 13.2%), v) food and nutrition expertise (n= 10; 13.2%), and vi) population health promotion (n= 9; 11.8%). Recommendations for future research and programming are discussed. CONCLUSIONS This scoping review demonstrates that current programming relies heavily on charitable food provision services for people living with HIV and that there is an unequal distribution of resources across Canada. Program expansion to target diverse populations with more equal distribution across Canada may improve overall health outcomes for people living with HIV. Future research is needed to evaluate the effectiveness of available programming and the needs of end users (people living with HIV and their supports). FoodNOW will build on these findings to further explore and address the needs of people living with HIV. REVIEW REGISTRATION Open Science Framework https://osf.io/97x3r.
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Affiliation(s)
- Jessica Mannette
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Yingying Zhang
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Melissa Rothfus
- WK Kellogg Health Sciences Library, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | - Chelsey Purdy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Winta Tesfatsion
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Mary Lynch
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Patricia L. Williams
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
- Food Action Research Centre (FoodARC), Mount Saint Vincent University, Halifax, NS, Canada
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
- Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS, Canada
- Departments Pediactrics, Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
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Aidala AA, Wilson MG, Shubert V, Gogolishvili D, Globerman J, Rueda S, Bozack AK, Caban M, Rourke SB. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review. Am J Public Health 2015; 106:e1-e23. [PMID: 26562123 DOI: 10.2105/ajph.2015.302905] [Citation(s) in RCA: 242] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking "upstream" economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual's control that affect housing and residential environments and the health resources or risk exposures such contexts provide. OBJECTIVES We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. SEARCH METHODS We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. SELECTION CRITERIA We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in high-income countries. We defined housing status to include consideration of material or social dimensions of housing adequacy, stability, and security of tenure. DATA COLLECTION AND ANALYSIS Two independent reviewers performed data extraction and quality appraisal. We used the Cochrane Risk of Bias Tool for randomized controlled trials and a modified version of the Newcastle Ottawa Quality Appraisal Tool for nonintervention studies. In our quality appraisal, we focused on issues of quality for observational studies: appropriate methods for determining exposure and measuring outcomes and methods to control confounding. RESULTS Searches yielded 5528 references from which we included 152 studies, representing 139,757 HIV-positive participants. Most studies were conducted in the United States and Canada. Studies examined access and utilization of HIV medical care, adherence to antiretroviral medications, HIV clinical outcomes, other health outcomes, emergency department and inpatient utilization, and sex and drug risk behaviors. With rare exceptions, across studies in all domains, worse housing status was independently associated with worse outcomes, controlling for a range of individual patient and care system characteristics. CONCLUSIONS Lack of stable, secure, adequate housing is a significant barrier to consistent and appropriate HIV medical care, access and adherence to antiretroviral medications, sustained viral suppression, and risk of forward transmission. Studies that examined the history of homelessness or problematic housing years before outcome assessment were least likely to find negative outcomes, homelessness being a potentially modifiable contextual factor. Randomized controlled trials and observational studies indicate an independent effect of housing assistance on improved outcomes for formerly homeless or inadequately housed people with HIV. Housing challenges result from complex interactions between individual vulnerabilities and broader economic, political, and legal structural determinants of health. The broad structural processes sustaining social exclusion and inequality seem beyond the immediate reach of HIV interventions, but changing housing and residential environments is both possible and promising.
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Affiliation(s)
- Angela A Aidala
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Michael G Wilson
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Virginia Shubert
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - David Gogolishvili
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Jason Globerman
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Sergio Rueda
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Anne K Bozack
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Maria Caban
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
| | - Sean B Rourke
- Angela A. Aidala is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Michael G. Wilson is with the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Virginia Shubert is with Shubert Botein Policy Associates, New York, NY. At the time of this study, David Gogolishvili, Jason Globerman, Sergio Rueda, and Sean B. Rourke were with the Ontario HIV Treatment Network, Toronto, ON, Canada. Anne K. Bozack is with the Department of Environmental Health Sciences, Mailman School of Public Health. Maria Caban is with the Department of Research and Evaluation, BOOM!Health, New York, NY
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Patterson S, Cescon A, Samji H, Cui Z, Yip B, Lepik KJ, Moore D, Lima VD, Nosyk B, Harrigan PR, Montaner JSG, Shannon K, Wood E, Hogg RS. Cohort Profile: HAART Observational Medical Evaluation and Research (HOMER) cohort. Int J Epidemiol 2015; 44:58-67. [PMID: 24639444 PMCID: PMC4339756 DOI: 10.1093/ije/dyu046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 11/13/2022] Open
Abstract
Since 1986, antiretroviral therapy (ART) has been available free of charge to individuals living with HIV in British Columbia (BC), Canada, through the BC Centre of Excellence in HIV/AIDS (BC-CfE) Drug Treatment Program (DTP). The Highly Active Antiretroviral Therapy (HAART) Observational Medical Evaluation and Research (HOMER) cohort was established in 1996 to maintain a prospective record of clinical measurements and medication profiles of a subset of DTP participants initiating HAART in BC. This unique cohort provides a comprehensive data source to investigate mortality, prognostic factors and treatment response among people living with HIV in BC from the inception of HAART. Currently over 5000 individuals are enrolled in the HOMER cohort. Data captured include socio-demographic characteristics (e.g. sex, age, ethnicity, health authority), clinical variables (e.g. CD4 cell count, plasma HIV viral load, AIDS-defining illness, hepatitis C co-infection, mortality) and treatment variables (e.g. HAART regimens, date of treatment initiation, treatment interruptions, adherence data, resistance testing). Research findings from the HOMER cohort have featured in numerous high-impact peer-reviewed journals. The HOMER cohort collaborates with other HIV cohorts on both national and international scales to answer complex HIV-specific research questions, and welcomes input from external investigators regarding potential research proposals or future collaborations. For further information please contact the principal investigator, Dr Robert Hogg (robert_hogg@sfu.ca).
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Affiliation(s)
- Sophie Patterson
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Angela Cescon
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hasina Samji
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Benita Yip
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Katherine J Lepik
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Viviane D Lima
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Bohdan Nosyk
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - P Richard Harrigan
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kate Shannon
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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