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The effect of gender on food insecurity among HIV-infected people receiving anti-retroviral therapy: A systematic review and meta-analysis

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  • Dube Jara Boneya
  • Ahmed Ali Ahmed
  • Alemayehu Worku Yalew

Abstract

Background: HIV-infected adults receiving anti-retroviral therapy have a high prevalence of food insecurity in both high- and low-income settings., Women bear an inequitable burden of food insecurity due to lack of control over resources and over household food allocation decision-making. The few studies conducted on the association between food insecurity and gender among HIV-infected adults have inconclusive findings. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled effect of gender on food insecurity among HIV-infected adults receiving antiretroviral therapy. Method: We conducted an electronic, web-based search using PubMed, CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library, the Web of Science and Google Scholar. We included studies which reported the association between food insecurity and gender among HIV-infected adults receiving antiretroviral therapy whose age was greater than 18 years. The analysis was conducted using STATA 14 software. A random effects model was used to estimate the pooled effect a 95% confidence interval(CI). Forest plots were used to visualize the presence of heterogeneity. Funnel plots and Egger’s and Begg’s tests were used to check for publication bias. Results: A total of 776 studies were identified of which seventeen studies were included in the meta-analysis, with a total of 5827 HIV infected adults receiving antiretroviral therapy. We found that the gender of HIV-infected adults receiving anti-retroviral therapy had statistically significant effects on food insecurity. The pooled odds of developing food insecurity among female HIV infected adults receiving anti-retroviral therapy was 53% higher than male HIV infected adults (OR: 1.53, 95% CI: 1.29, 1.83). Our analysis indicate the findings of studies conducted in the high-income countries showed weakest associations between gender and food insecurity than those conducted in low- and middle-income countries. Conclusion: Our systematic review and meta-analysis showed statistically significant effect of gender on food insecurity among HIV-infected adults receiving anti-retroviral therapy in which odds of food insecurity was higher among female HIV infected adults compared to male HIV-infected adults. These findings suggest that the need to include within food and nutrition interventions for HIV-infected adults receiving antiretroviral treatment, culture- and context-specific gender-based policies to address the sex/gender related vulnerability to food insecurity.

Suggested Citation

  • Dube Jara Boneya & Ahmed Ali Ahmed & Alemayehu Worku Yalew, 2019. "The effect of gender on food insecurity among HIV-infected people receiving anti-retroviral therapy: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0209903
    DOI: 10.1371/journal.pone.0209903
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    1. Aranka Anema & Sarah J Fielden & Susan Shurgold & Erin Ding & Jennifer Messina & Jennifer E Jones & Brian Chittock & Ken Monteith & Jason Globerman & Sean B Rourke & Robert S Hogg & Canada Food Securi, 2016. "Association between Food Insecurity and Procurement Methods among People Living with HIV in a High Resource Setting," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-20, August.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Tsai, Alexander C. & Bangsberg, David R. & Frongillo, Edward A. & Hunt, Peter W. & Muzoora, Conrad & Martin, Jeffrey N. & Weiser, Sheri D., 2012. "Food insecurity, depression and the modifying role of social support among people living with HIV/AIDS in rural Uganda," Social Science & Medicine, Elsevier, vol. 74(12), pages 2012-2019.
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    1. Nadjeanny Ingrid Galdino Gomes & Rodrigo Pinheiro de Toledo Vianna & Amira Rose Costa Medeiros & Rafaela Lira Formiga Cavalcanti Lima, 2020. "Nutritional risk, food insecurity and quality of life in people living with HIV/AIDS in Paraíba, Brazil," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 12(5), pages 1173-1183, October.

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