A systematic review of qualitative research on HIV and food insecurity in high-income countries

26/05/2026

AI Summary

Structural inequalities shape and constrain experiences of food insecurity among people living with HIV in high-income countries.
Food insecurity contributes to obesity, poor mental health and viral non-suppression, amplifying adverse health outcomes for people living with HIV.
The labour of procuring food is burdensome; interventions must address intersecting social and structural conditions shaping food insecurity.

TL;DR (AI Generated)

However, limited qualitative research exists on the lived experiences of food insecurity among people living with HIV in high income countries (HICs).

We identified three key themes, each with their own sub-themes: the role of structural inequalities in shaping and navigating food insecurity; the impacts of food insecurity on health and wellbeing; and the labour of procuring of food.

Basic summary

AIDS. 2026 May 26. doi: 10.1097/QAD.0000000000004552. Online ahead of print.

ABSTRACT

OBJECTIVES: Food insecurity leads to adverse health outcomes in people living with HIV, including obesity, poor mental health and viral non-suppression. Qualitative studies in low- and middle-income countries have described the impact of food insecurity on medication adherence. However, limited qualitative research exists on the lived experiences of food insecurity among people living with HIV in high income countries (HICs). We aimed to synthesize qualitative literature on food insecurity among people living with HIV in HICs.

DESIGN: Systematic review and textual narrative synthesis.

METHODS: We searched MEDLINE, CINAHL, Scopus, Embase, and PsycINFO, extracting data from included articles on a standardised form in Covidence. We synthesised literature using a textual narrative approach. We conducted quality appraisal (Critical Appraisal Skills Programme Qualitative Studies Checklist) and graded certainty of findings (GRADE-CERQual).

RESULTS: We reviewed 2772 articles, reduced to 940 after deduplication, with 12 articles included after full text screening. Included articles reported on studies conducted in the United States (n = 7), and Canada (n = 5). We identified three key themes, each with their own sub-themes: the role of structural inequalities in shaping and navigating food insecurity; the impacts of food insecurity on health and wellbeing; and the labour of procuring of food.

CONCLUSIONS: Our review highlights the syndemic nature of food insecurity and HIV; intersecting experiences of multiple structural hardships constellate and interact synergistically to amplify poor health outcomes. Interventions should address the multiple and reinforcing social and structural conditions that shape food insecurity among people living with HIV.

PMID:42186786 | DOI:10.1097/QAD.0000000000004552

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