Within HIV care, food security is not simply a quality-of-life issue. It’s a critical component of achieving and sustaining viral suppression for anyone living with HIV.
According to the latest findings from the Centers for Disease Control and Prevention’s Medical Monitoring Project, approximately 22% of adults living with diagnosed HIV reported experiencing hunger or food insecurity. For many, these challenges adversely affect their ability to consistently take HIV medication and remain engaged in care.
Treatment as Prevention (TasP) serves as the foundation for Undetectable = Untransmittable (U=U), the scientifically proven principle that people living with HIV who achieve and maintain viral suppression can’t sexually transmit HIV.
Yet this public health success becomes increasingly difficult to realize when people living with HIV can’t reliably access affordable, nutritious food. Food insecurity is not merely a barrier to good nutrition. It’s a barrier to treatment adherence, viral suppression, and long-term health equity.
Even more telling, many of the regions in the United States with the highest HIV burden are also among the regions experiencing the highest levels of hunger, including Florida, Georgia, Texas, Mississippi, Louisiana, Puerto Rico, and Washington, D.C.
This shouldn’t surprise us.
Both HIV and hunger thrive where poverty is entrenched, healthcare access is inconsistent, and structural inequities limit opportunity. The same communities facing the greatest barriers to health are too often the same communities expected to overcome HIV without the stability and resources necessary to do so.
This may seem coincidental, but we know better. The conditions that drive food insecurity are often the same conditions that undermine HIV outcomes, making it impossible to address one challenge while ignoring the other.
Food security must be recognized as a component of HIV care rather than a separate social concern. Prioritizing expanded access to nutrition services, medically tailored meals, produce prescription programs, easy Supplemental Nutrition Assistance Program enrollment, and community-based food partnerships should be central to any serious strategy for ending the HIV epidemic.
Yet many of these interventions remain underfunded despite evidence that they help people living with HIV remain engaged in care and maintain viral suppression. One may want to ask Congress: Are we trying to end the HIV epidemic or not?
When people living with HIV have reliable access to nutritious food, they are better equipped to remain engaged in care, adhere to treatment, and achieve improved health outcomes. If food insecurity stands between a person and viral suppression, then food is not ancillary to HIV care. Food is HIV care.
Dominic Calhoun is a public health statistician and advocacy journalist serving as Senior Program Manager of Advocacy at AIDS Healthcare Foundation.
