a1 Division of Infectious Diseases, School of Medicine, Emory University, 69 Jesse Hill Jr. Drive – SE, Atlanta, GA 30303, USA
a2 Department of Anthropology, Emory University, Atlanta, GA, USA
a3 School of Social Work, Barry University, Miami Shores, FL, USA
a4 Division of Infectious Diseases, Miller School of Medicine, University of Miami, Miami, FL, USA
a5 Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA
a6 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Objective To measure the occurrence and correlates of food insufficiency among HIV-infected crack-cocaine users in Atlanta and Miami, USA.
Design Non-probability cross-sectional sample.
Setting Inner-city hospitals in Atlanta and Miami.
Subjects Two hundred and eighty-seven HIV-infected crack users.
Results One-third (34 %) of respondents experienced food insufficiency within 30 d of interview. Increased odds of food insufficiency was associated with current homelessness (adjusted OR = 3·78, 95 % CI 1·70, 8·41), living alone (adjusted OR = 2·85, 95 % CI 1·36, 5·98), religious service attendance (adjusted OR = 2·34, 95 % CI 1·02, 5·38) and presence of health insurance (adjusted OR = 2·41, 95 % CI 1·06, 5·54). Monthly income greater than $US 600 (adjusted OR = 0·19, 95 % CI 0·06, 0·58) was associated with decreased odds of food insufficiency, and less than weekly crack use was marginally associated with decreased odds of food insufficiency (adjusted OR = 0·39, 95 % CI 0·13, 1·08).
Conclusions Food insufficiency is very prevalent among HIV-infected urban crack-cocaine users in Atlanta and Miami. Correlates of food insufficiency confirm the social vulnerability of these individuals. Routine assessment for food insecurity should become a routine component of treatment and prevention programmes in at-risk populations.
(Received June 15 2009)
(Accepted December 09 2009)
(Online publication January 15 2010)