(P17-026-23) Prevalence of Household Food Insecurity Among HIV+ Smokers Receiving Treatment at HIV Clinics in Hanoi

Objectives: Food insecurity (FI), defined as the lack of consistent access to food of sufficient quality and/or quantity, is a known predictor of tobacco use and of HIV acquisition and progression. However, there is limited understanding of how FI, HIV, and tobacco use intersect. Independent of tobacco use, FI is associated with poor health outcomes in HIV populations. Also, people living with HIV (PWH) who smoke experience worse health outcomes than PWH who do not smoke. The health impacts of FI can exacerbate the already significant risks that are associated with smoking among PWH. Thus, FI may partially explain the poorer HIV-related health outcomes observed among PWH who experience concomitant FI and tobacco use. In many low- and middle-income countries (LMIC) with dual burdens of HIV and tobacco use, the prevalence of FI among PHW who smoke is unknown. The objective of this study is to characterize household FI among PLH who smoke in Vietnam.

Methods: We surveyed 182 smokers receiving HIV care at 5 clinics in Hanoi, Vietnam. We estimated the proportion of FI among our sample using the Household Food Insecurity Access Scale and analyzed covariates associated with FI, like income, and moderators of smoking, like drug use. 

Results: FI was reported by 14% of our sample. The mean (SD) of years living with HIV was 12.8 (6.45). Of those reporting FI, 68% (n=17) reported significant depression symptoms, almost twice as many as food secure smokers 37% (n=58) [(RR 1.84 (1.31-2.58); p = 0.004)]; while 40% (n=10) reported drug use, 18% more than food secure smokers 22% (n=34) [(RR 1.85 (1.05-3.25); p = 0.075)]. Tobacco dependence [RR=1.86 (1.40, 2.49); p = 0.001] and trying to quit smoking [(RR=0.45 (0.24, 0.86); p = 0.002] were associated with moderate-to-severe FI.

Conclusions: Our findings suggest PWH who smoke are vulnerable to FI and face very high or high tobacco addiction. We also find evidence that FI is linked to several other conditions that alone or together are barriers to quitting.  Considering these findings and the increasing interest in HIV and co-existing chronic conditions like smoking and FI, further research is needed to understand how FI and tobacco use intersect and impact PWH who experience both FI and tobacco use.

Funding Sources: National Cancer Institute, National Institutes of Health