Research Papers

@article{W2020,
title = {The Mediating Role of Depressive Symptoms in the Association Between Food Insecurity and HIV Related Health Outcomes Among HIV-HCV Co-Infected People},
author = {Aibibula W and Cox J and Hamelin AM and Klein MB and Brassard P},
url = {https://pubmed.ncbi.nlm.nih.gov/31950306/},
doi = {10.1007/s10461-020-02784-7},
year = {2020},
date = {2020-07-01},
journal = {AIDS and Behaviour},
abstract = {Food insecurity may lead to depressive symptoms, which are known to be associated with poor HIV related health outcomes. However, it is unclear to what extent food insecurity 'directly' affects these outcomes. We used data from the Food Security & HIV-HCV Sub-Study of the Canadian Co-Infection Cohort to assess the controlled direct effect. People experiencing severe food insecurity had 1.47 (95% CI 1.04-2.09) times the risk of having detectable HIV viral load and 0.94 (95% CI 0.87-1.02) fold change in CD4 count. After holding depressive symptoms constant, the association between severe food insecurity and HIV viral load was attenuated to a statistically non-significant level (RR 1.36, 95% CI: 0.95-1.96), whereas the association between severe food insecurity and CD4 count was unchanged. Depressive symptoms partially mediate the effect of severe food insecurity on HIV viral suppression; interventions focused on depressive symptoms alone may not be sufficient, however, to eliminate this effect.},
keywords = {CD4 count, Food insecurity, HIV viral load, HIV-HCV co-infection, Mediation analysis},
pubstate = {published},
tppubtype = {article}
}

@article{W2018b,
title = {Association between depressive symptoms, CD4 count and HIV viral suppression among HIV-HCV co-infected people},
author = {Aibibula W and Cox J and Hamelin AM and Moodie EEM and Anema A and Klein MB and Brassard P},
url = {https://pubmed.ncbi.nlm.nih.gov/29374972/},
doi = {10.1080/09540121.2018.1431385},
year = {2018},
date = {2018-05-01},
journal = {AIDS Care},
abstract = {Depressive symptoms are associated with poor HIV viral control and immune recovery among people living with HIV. However, no prior studies assessed this association exclusively among people co-infected with HIV-hepatitis C virus (HCV). While people with HIV only and those with HIV-HCV co-infection share many characteristics, co-infected people may become more susceptible to the effects of depressive symptoms on health outcomes. We assessed this association exclusively among people co-infected with HIV-HCV in Canada using data from the Food Security & HIV-HCV Sub-Study (FS Sub-Study) of the Canadian Co-Infection Cohort (CCC). Stabilized inverse probability weighted marginal structural model was used to account for potential time-varying confounders. A total of 725 participants were enrolled between 2012 and 2015. At baseline, 52% of participants reported depressive symptoms, 75% had undetectable HIV viral load, and median CD4 count was 466 (IQR 300-665). People experiencing depressive symptoms had 1.32 times (95% CI: 1.07, 1.63) the risk of having detectable HIV viral load, but had comparable CD4 count to people who did not experience depressive symptoms (fold change of CD4 = 0.96, 95% CI: 0.91, 1.03). Presence of depressive symptoms is a risk factor for incomplete short-term HIV viral suppression among people co-infected with HIV-HCV. Therefore, depressive symptoms screening and related counseling may improve HIV related health outcomes and reduce HIV transmission.},
keywords = {CD4 count, Depressive symptoms, HIV viral load, HIV-HCV co-infection, Marginal structural models},
pubstate = {published},
tppubtype = {article}
}

@article{W2018,
title = {Food insecurity may lead to incomplete HIV viral suppression and less immune reconstitution among HIV/hepatitis C virus-coinfected people},
author = {Aibibula W and Cox J and Hamelin AM and Moodie EEM and Naimi AI and McLinden T and Klein MB and Brassard P},
url = {https://pubmed.ncbi.nlm.nih.gov/29094807/},
doi = {10.1111/hiv.12561},
year = {2018},
date = {2018-02-01},
journal = {HIV Medicine},
abstract = {Objectives: The aim of this study was to determine the impact of food insecurity (FI) on HIV viral load and CD4 count among people coinfected with HIV and hepatitis C virus (HCV).

Methods: This study was conducted using data from the Food Security & HIV-HCV Sub-Study of the Canadian Co-Infection Cohort study. FI was measured using the adult scale of Health Canada's Household Food Security Survey Module and was classified into three categories: food security, moderate food insecurity and severe food insecurity. The association between FI, HIV viral load, and CD4 count was assessed using a stabilized inverse probability weighted marginal structural model.

Results: A total of 725 HIV/HCV-coinfected people with 1973 person-visits over 3 years of follow-up contributed to this study. At baseline, 23% of participants experienced moderate food insecurity and 34% experienced severe food insecurity. The proportion of people with undetectable HIV viral load was 75% and the median CD4 count was 460 [interquartile range (IQR): 300-665] cells/μL. People experiencing severe food insecurity had 1.47 times [95% confidence interval (CI): 1.14, 1.88] the risk of having detectable HIV viral load and a 0.91-fold (95% CI: 0.84, 0.98) increase in CD4 count compared with people who were food secure.

Conclusions: These findings provide evidence of the negative impact of food insecurity on HIV viral load and CD4 count among HIV/HCV-coinfected people.},
keywords = {CD4 count, Food insecurity, HIV viral load, HIV-HCV co-infection, Marginal structural models},
pubstate = {published},
tppubtype = {article}
}