“I do my best to eat while I'm using”: Mapping the foodscapes of people living with HIV/AIDS who use drugs

• Published in: Social science & medicine (1982) 2019-04, Vol.226, p.96-103
• Main Authors: Miewald, Christiana, McCann, Eugene, Temenos, Cristina, McIntosh, Alison
• Format: Article
• Language: English
• Subjects: Access; Acquired immune deficiency syndrome; Adult; AIDS; Canada; Clinical outcomes; Drug abuse; Drug use; Drug Users - psychology; Drug Users - statistics & numerical data; Drugs; Feeding Behavior - psychology; Female; Food; Food security; Food Supply; Foodscape; Health behavior; Health problems; Health status; Healthy food; HIV; HIV Infections - complications; HIV Infections - diet therapy; HIV/AIDS; Human immunodeficiency virus; Humans; Insecurity; Interviews as Topic - methods; Male; Mapping; Middle Aged; Morbidity; Nutrition; Qualitative Research; Risk; Risk taking; Semistructured questionnaires; Social Support; Unsafe
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2019.02.037

Food insecurity can have negative health impacts on people who use drugs and are living with HIV/AIDS (PLHIV). These include both physical effects, including poorer health outcomes and morbidity, and also behaviors that can increase the risk of physical or psychological harm. This study used a semi-structured survey of 60 PLHIV who use drugs and service access mapping (SAM) interviews of a 20-person subset. The mapping helped to illustrate the daily routines used to access food and how food provision may contribute to both spaces of risk and care for a cohort of PLHIV who use drugs in Vancouver, BC. Study participants mapped the daily routes used to access food and discussed whether they felt that these routines increased their risk of physical harm. Additionally, study participants noted which food provision spaces provide social and health supports, which may protect against the nutritional and other harms of drug use. This study revealed that having access to space providing stable and reliable sources of food may protect individuals from experiencing certain risks associated with accessing food, including violence in food line-ups, having to enter areas of the city they considered unsafe or ‘triggering’ and engaging in risky behaviors in order to access food. These “spaces of care” not only provide nutrition but also social support and connections. •Illicit drug use affects diet and food security for People Living with HIV/AIDS.•Accessing food may put PLHIV who use drugs at greater risk of physical/mental harm.•Stable and reliable sources of food protect PLHIV from experiencing certain risks.