Insegurança alimentar e fatores associados em pessoas que vivem com HIV/AIDS atendidas na rede pública e residentes em Fortaleza-CE

Abstract

Food insecurity occurs when there is a violation of the right to eat with dignity, there is the impossibility of adequate, safe and sufficient access to food and nutrients. Considered as one of the main causes of morbidity and mortality worldwide, food insecurity is closely associated with the HIV epidemic. This work aims to analyze the association between food insecurity and related factors in people living with HIV/AIDS assisted in the public network and residing in Fortaleza-CE. This is a cross-sectional, analytical study with a quantitative approach. The research was carried out with 359 people with HIV/AIDS, over 18 years old, in outpatient treatment, assisted in the public network and residing in the city of Fortaleza-CE. Data collection was carried out in three health units, selected because they jointly serve more than 60% of notified cases of HIV/AIDS in the municipality. The collection period was from July to December 2019. The AIDS diagnosis was established according to the modified CDC and Rio/Caracas criteria. For data collection, medical records were consulted and a structured questionnaire was interviewed. Through a questionnaire, anthropometric, demographic, socioeconomic, clinical, epidemiological, food consumption and food insecurity data were obtained. The classification of the nutritional status of each participant was performed using the Body Mass Index (BMI). To classify the level of food insecurity or attest to the food security of the sample, the assessment criteria of the Brazilian Scale of Food Insecurity (EBIA) were used. Food consumption was assessed using the Food and Nutrition Surveillance System (SISVAN) instrument. In the statistical analysis, the Mann-Whitney test was used for numerical variables and Fisher's exact test and Pearson's chi-square test for categorical variables, with a significance level of 5% (p<0.05) and adjustments with logistic regression for variables with p<0.20. Of the 359 patients interviewed, 186 (51.5%) were food insecure. The diagnosis of insecurity was associated with the variables gender, education, income, government assistance, source of tap water, CD4+ T cell count, having lunch, consumption of vegetables and physical activity (P<0.05 ). After adjustments with Poisson regression, only the variables sex, income and consumption of the main meal, lunch, remained associated with the food insecurity outcome. Food insecurity remained more prevalent among women (PR=1.08), in individuals who received less than one minimum wage (RP=1.37) and from one to two minimum wages (RP=1.31) , in those who ate lunch, AI remained less prevalent (PR=0.8). The results of this study show a high prevalence of food insecurity for the population of people living with HIV/AIDS investigated. Addressing food insecurity must become an integral part of HIV treatment, consistent with the objective of supporting HIV-infected individuals in meeting basic needs, ensuring comprehensive care, a principle of the Unified Health System (SUS).