'When you take pills you must eat': Food (in)security and ART adherence among older people living with HIV

South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing re...

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Bibliographic Details
Published in:Global public health 2020-01, Vol.15 (1), p.97-110
Main Authors: Knight, Lucia, Schatz, Enid, Lewis, Kaleea R., Mukumbang, Ferdinand C.
Format: Article
Language:English
Subjects:
Adherence
Antiretroviral drugs
Antiretroviral therapy
Content analysis
Data collection
Family roles
Food
Food consumption
Food security
Health care
Health care industry
Healthy food
HIV
Human immunodeficiency virus
Humanitarian aid
Insecurity
Medical personnel
Medical treatment
Morbidity
Older people
Patient compliance
Qualitative analysis
Social welfare
South Africa
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Summary:South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing research is largely limited to those aged 15-49 years. In this paper, we therefore explore how older people living with HIV (OPLWH) in two urban communities within South Africa negotiate and ensure they have sufficient access to food and how food insecurity may affect their retention in care and ART adherence. This study used exploratory qualitative semi-structured in-depth interviews with 23 OPLWH to collect data in isiXhosa. Data were analysed using thematic content analysis. Factors at the community, household and individual levels influence (a) access to sufficient and quality food, and (b) beliefs about ART and food based on (mis)understandings of messaging from health care providers. The results demonstrate the need to explore further and clarify the nutritional guidelines that OPLWH receive from providers to ensure this does not result in reduced adherence or retention in care. They also demonstrate the role that social welfare and family or kin obligations plays in ensuring the food security of OPLWH.
ISSN:1744-1692
1744-1706
DOI:10.1080/17441692.2019.1644361