Hunger, HIV and Health: How food insecurity and HIV treatment are connected

By Julie Lifshay, MPH, PhD, Director of Health Navigation

As the chilly fall weather sets in, many of us are starting to turn our thoughts to how we’ll celebrate the upcoming holidays—with family, loved ones and lots of good food.

We’ll see food banks, religious institutions, grocery markets and even places like movie theaters start to ask for donations of canned goods. Just recently during the Jewish High Holy Days, my synagogue collected non-perishable food items to donate to those in need of food.

For many of us, food holds great significance. We pass down cultural meaning and practices in the process of preparing and eating traditional dishes together. Certain foods may remind us of people, places and times in our lives. The preparation of meals or dishes can be an expression of love and warmth and in these cases—the food fills not only our stomachs, but also our hearts.

With ready access to the foods we want and enjoy, it can be easy to forget that food is necessary to sustain life—and that some people don’t have this same luxury.

People with food insecurity have a “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways,” according to the USDA. People who are food insecure may worry that food will run out before there is enough money to buy more. They may not be able to afford to eat balanced meals, and may reduce the size of or skip meals without enough money for food. 

At San Francisco AIDS Foundation, we worry about food insecurity because of its close ties to health. Research has shown that food insecurity among people living with HIV is independently associated with symptoms of depressionPeople living with HIV who are food insecure are less likely to access HIV treatment and more likely to have poor adherence to HIV medications (and this association is independent of other factors, like how much money people have). People living with HIV who are food insecure are also at higher risk of being hospitalized or going to the emergency room.

Many clients who come to the foundation for services don’t live with the security of knowing where their next meal will come from. Although our programs are largely focused on helping clients acquire medical care, adhere to treatment, or reduce behaviors that may cause them harm, we always keep in mind that food is fundamental to supporting the health and well-being of our community.

Most of the foundation’s community groups and events provide a healthy meal as an integral part of the program.

The team that greets visitors and manages the lobby at our 1035 Market Street headquarters ensures there are healthy snacks available for anyone who walks through our doors. Several of our programs—Positive Force, BBE, DREAAM, Black Health and Access Hope Centers of Excellence, TransLife, Latino Programs and the Elizabeth Taylor 50-Plus Network—all host regular events with dinner. Our Centers of Excellence and Health Navigation programs also offer food vouchers as part of providing case management to HIV-positive clients attempting to access or stay in care. A central part of the Latino Programs services is the making of traditional foods by and for participants in our kitchen. And the evening and weekend events at Strut, such as Black Love, PrEP Rallies, art openings and others provide a variety of dishes, lighter snacks and deserts for attendees.

Food brings our communities together, unites us as human beings, and allows us at San Francisco AIDS Foundation to support our clients in their journeys to health. November 11 – 19 is National Hunger & Homelessness Awareness Week. During this time and throughout the holidays, I hope you take time to reflect on the role that food plays in creating celebrations, bringing you closer to loved ones, and sustaining your health.


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