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Clarke A, Tesfatsion W, Mannette J, Hamilton-Hinch BA, Williams P, Grant S, Joy P. Exploring Food and Nutrition Programming for People Living With HIV/AIDS: Interviews With Service Providers in Nova Scotia, Canada. Health Promot Pract 2024; 25:657-665. [PMID: 36929730 DOI: 10.1177/15248399231160758] [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: 03/18/2023]
Abstract
There is a lack of nutritional programming and resources available for people living with HIV/AIDS (PLWHA) in Nova Scotia, Canada. This is problematic for several reasons, including that adequate food and nutrition knowledge is integrated to effective medical therapy and wellness for PLWHA. The aim of this research was to explore and describe the beliefs, values, and experiences of HIV-service providers involved programming for PLWHA in Nova Scotia. Using a post-structuralist lens, semi-structured interviews were conducted with nine service providers. Thematic analysis of interview transcripts identified four main themes: (1) recognizing the social determinants of health, (2) acknowledging and disrupting layered stigma, (3) understanding the commensality, and (4) navigating and utilizing networks of care. These findings suggest that those developing, delivering, and evaluating food and nutrition-related programming must engage in community-inclusive approaches that recognize the varied social determinants of health that shape the lived of PLWHA, leverage existing networks and resources, and actively disrupt layered stigma. Also, in agreement with existing evidence, participants stressed the value of communicating and supporting the practice of eating together (commensality) and cultivating networks of care.
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Affiliation(s)
- Abigail Clarke
- Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | | | | | | | | | - Shannan Grant
- Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Phillip Joy
- Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Bleasdale J, Morse GD, Liu Y, Leone LA, Cole K, Przybyla S. Addressing food insecurity in HIV care: perspectives from healthcare and social service providers in New York state. AIDS Care 2024:1-10. [PMID: 38289486 DOI: 10.1080/09540121.2024.2309331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 01/18/2024] [Indexed: 05/05/2024]
Abstract
Ending the HIV epidemic in the United States will require addressing social determinants contributing to poor care engagement among people living with HIV (PLH), such as food insecurity. Food insecurity is associated with poor care engagement among PLH. Yet, few studies have examined the perspectives of healthcare and social services providers on addressing food insecurity in HIV care. Guided by the Social Ecological Model, we conducted semi-structured interviews with 18 providers in New York State to understand barriers and facilitators to addressing food insecurity in HIV care. Thematic analysis illustrated eight themes across various levels of the Social Ecological Model. At the patient-level, providers perceived patients' feelings of embarrassment, shame, and judgement, and low health literacy as barriers. At the provider-level, challenges included limited time. Facilitators included fostering strong, patient-provider relationships. Barriers at the clinic-level included limited funding, while clinic resources served as facilitators. At the community-level, challenges included intersecting stigmas arising from community norms towards PLH and people who receive food assistance and limited access to healthy food. Findings suggest the need to incorporate their insights into the development of interventions that address food insecurity in HIV care.
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Affiliation(s)
- Jacob Bleasdale
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Gene D Morse
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
- Center for Integrated Global Biomedical Sciences, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Yu Liu
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Lucia A Leone
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Kenneth Cole
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Sarahmona Przybyla
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
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Joy P, Hammond C, Hammond B, Clarke A, Mannette J, Hamilton-Hinch BA, Grant S. Disciplined appetites: Reimagining food and nutrition programs for people living with HIV and AIDS. Nutr Diet 2023; 80:521-529. [PMID: 36941202 DOI: 10.1111/1747-0080.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/20/2022] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
AIMS Medical nutrition therapy is recommended for people living with HIV/AIDS to improve health and wellness; however, there is a lack of food and nutrition programs for people living with HIV/AIDS in Nova Scotia, Canada. The aim of this study was to explore the beliefs, values, and experiences of people living with HIV/AIDS in relation to food and nutrition programs. METHODS A critical social theory lens with two disciplinary contexts: critical health geography and critical dietetics guided this research. Semi-structured interviews were conducted with 12 people living with HIV/AIDS and analysed for themes. RESULTS The three main themes were identified: (1) intersections of social determinants of health, wellness, and food security; (2) discursive shaping of food and nutrition in relation to HIV; and (3) the dynamic nature of HIV care. CONCLUSIONS Participants offered recommendations on how food and nutrition programs might be reimagined to be more accessible, inclusive, and effective for people living with HIV/AIDS.
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Affiliation(s)
- Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Chad Hammond
- University of Saskatchewan, College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Brianna Hammond
- Nascent Knowledge Consulting, Saskatoon, Saskatchewan, Canada
| | - Abigail Clarke
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Jessica Mannette
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | | | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Departments of Pediatrics, Obstetrics, and Gynaecology, IWK Health, Halifax, Nova Scotia, Canada
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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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Mannette J, Zhang Y, Rothfus M, Purdy C, Tesfatsion W, Lynch M, Hamilton-Hinch B, Williams P, Joy P, Grant S. Exploring current nutritional programming and resources available to people living with HIV/AIDs in Canada: a scoping review protocol. JBI Evid Synth 2022; 20:2781-2789. [PMID: 36081361 DOI: 10.11124/jbies-21-00369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The objective of this scoping review is to map the current literature and resources available on nutrition and food programming for people living with HIV/AIDS in Canada. This review is phase 1 of a 4-phase, provincially funded project called FoodNOW (Food to eNhance Our Wellness) focused on nutritional assessment of people living with HIV/AIDS in Nova Scotia, Canada. INTRODUCTION People living with HIV/AIDS may experience nutritional challenges, including food insecurity and nutrition-drug interactions. Nutritional programming is required for optimal care for people living with HIV/AIDS, however, there is a lack of information within the literature about current nutrition and food programming in Canada. This proposed review will investigate available programming and gaps. INCLUSION CRITERIA This review will consider literature focused on nutrition and food programming and resources in Canada for people living with HIV/AIDS. People living with HIV/AIDS of any age, sex, race, gender identity, or sexual orientation, including pregnant and lactating people living with HIV/AIDS, will be included as population of interest. METHODS The following databases will be searched: MEDLINE (EBSCO), CINAHL (EBSCO), Academic Search Premier (EBSCO), Social Services Abstracts (ProQuest), and Scopus. Types of gray literature eligible for review include reports from service providers and online public newspaper articles written by, with, or about people living with HIV/AIDS. Two independent reviewers will assess each study and any conflicts will be resolved through discussion. Data will be extracted by 2 independent reviewers. Results will be presented in tabular or diagrammatic format, with a narrative summary.
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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, 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.,QEII Health Sciences Centre, Halifax, NS, Canada
| | - Barb Hamilton-Hinch
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Patricia 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
| | - 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.,Departments Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada.,Departments of Pediatrics, Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
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Sernick A, Shannon K, Ranville F, Arora K, Magagula P, Shoveller J, Krüsi A. In the midst of plenty: Experiences of food insecurity amongst women living with HIV in Vancouver, Canada. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e138-e147. [PMID: 33978282 PMCID: PMC8586035 DOI: 10.1111/hsc.13420] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 02/18/2021] [Accepted: 04/08/2021] [Indexed: 06/12/2023]
Abstract
Globally, people living with HIV (PLWH) are disproportionately affected by food insecurity. Yet there is limited understanding of the impacts of food insecurity among cisgender and transgender women living with HIV (WLWH) in high-income countries. Thus, it is critical to examine the lived experiences of WLWH and food insecurity to inform policy and service provision. As part of the community-based SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment) study, we conducted 64 semistructured qualitative interviews with WLWH in Vancouver, Canada (2015-2017). Drawing on a socio-ecological framework, this analysis explores the lived experiences of navigating food security and health among WLWH in Metro Vancouver. Our findings indicate that WLWH relied heavily on food banks and other food-related supportive services. Despite the abundance of programs, access to nutritious foods remained difficult, and women often relied on processed foods that were more affordable and readily available. For many, food insecurity was exacerbated by unresponsive food services regulations that did not reflect the actual needs of food service users in terms of opening hours and locations, and a lack of nutritious food. Additionally, the absence of trauma-aware, women-centred and culturally responsive services, as well as, spatial and material barriers related to the recent loss of funding for HIV-specific support services, impeded food security among WLWH. Our findings emphasise that recognizing and addressing the social and structural disparities that exist for WLWH in high-income setting are essential for addressing food insecurity and ultimately optimal health among this population.
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Affiliation(s)
- Ariel Sernick
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Flo Ranville
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Kamal Arora
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Patience Magagula
- Afro-Canadian Positive Network of British Columbia, Surrey, British Columbia, Canada
| | - Jean Shoveller
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Izaak Walton Killam Health Centre, Halifax, Nova Scotia, Canada
| | - Andrea Krüsi
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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McKay FH, Lippi K, Dunn M. Investigating Responses to Food Insecurity Among HIV Positive People in Resource Rich Settings: A Systematic Review. J Community Health 2018; 42:1062-1068. [PMID: 28417433 DOI: 10.1007/s10900-017-0351-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Many of the 36.7 million people living with HIV are also assumed to be food insecure. The implications of food insecurity in people living with HIV are significant, with food insecurity associated with an increased likelihood of tobacco, alcohol, and illicit drug use, experiences of depression or depressive symptoms, poor adherence and delayed uptake of HIV medication, nutritional vulnerability leading to interference of medication, and the uptake of risky behaviours as a way to gain access to food resources. This review sought to present the current intervention research around the experiences of food insecurity in PLWHA in high resource countries to determine successful models to address the issue. Only five articles were identified in a systematic search, three reported on studies that were conducted in the USA and two in Canada. Two articles were cross sectional, one was a program evaluation, one ethnography, and one took a qualitative approach. This review highlights a lack of published research in the area of HIV and food insecurity in resource rich countries. The findings of this study suggest that there are currently no standard or best practice ways to provide food aid to PLWHA to reduce food security. The lack of published results means that while there may be good programs operating in the community, this information and knowledge is not being shared, resulting in a lack of consistency in approach, possible duplication, and the potential for wasted resources. Overall, this review suggests a need for more dedicated evaluation and longitudinal research.
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Affiliation(s)
- F H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood Campus, 221 Burwood Highway, Melbourne, VIC, 3125, Australia.
| | - K Lippi
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood Campus, 221 Burwood Highway, Melbourne, VIC, 3125, Australia
| | - M Dunn
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood Campus, 221 Burwood Highway, Melbourne, VIC, 3125, Australia
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Miewald C, McCann E, McIntosh A, Temenos C. Food as harm reduction: barriers, strategies, and opportunities at the intersection of nutrition and drug-related harm. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1359406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Eugene McCann
- Department of Geography, Simon Fraser University , Burnaby, Canada
| | - Alison McIntosh
- Department of Geography, Simon Fraser University , Burnaby, Canada
| | - Cristina Temenos
- Department of Geography, University of Manchester , Manchester, UK
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