| Title |
Injection Drug Use, Unemployment, and Severe Food Insecurity Among HIV-HCV Co-Infected Individuals: A Mediation Analysis
|
|---|---|
| Published in |
AIDS and Behavior, July 2017
|
| DOI | 10.1007/s10461-017-1850-2 |
| Pubmed ID | |
| Authors |
Taylor McLinden, Erica E. M. Moodie, Anne-Marie Hamelin, Sam Harper, Sharon L. Walmsley, Gilles Paradis, Wusiman Aibibula, Marina B. Klein, Joseph Cox |
| Abstract |
Severe food insecurity (FI), which indicates reduced food intake, is common among HIV-hepatitis C virus (HCV) co-infected individuals. Given the importance of unemployment as a proximal risk factor for FI, this mediation analysis examines a potential mechanism through which injection drug use (IDU) is associated with severe FI. We used biannual data from the Canadian Co-infection Cohort (N = 429 with 3 study visits, 2012-2015). IDU in the past 6 months (exposure) and current unemployment (mediator) were self-reported. Severe FI in the following 6 months (outcome) was measured using the Household Food Security Survey Module. An overall association and a controlled direct effect were estimated using marginal structural models. Among participants, 32% engaged in IDU, 78% were unemployed, and 29% experienced severe FI. After adjustment for confounding and addressing censoring through weighting, the overall association (through all potential pathways) between IDU and severe FI was: risk ratio (RR) = 1.69 (95% confidence interval [CI] = 1.15-2.48). The controlled direct effect (the association through all potential pathways except that of unemployment) was: RR = 1.65 (95% CI = 1.08-2.53). We found evidence of an overall association between IDU and severe FI and estimated a controlled direct effect that is suggestive of pathways from IDU to severe FI that are not mediated by unemployment. Specifically, an overall association and a controlled direct effect that are similar in magnitude suggests that the potential impact of IDU on unemployment is not the primary mechanism through which IDU is associated with severe FI. Therefore, while further research is required to understand the mechanisms linking IDU and severe FI, the strong overall association suggests that reductions in IDU may mitigate severe FI in this vulnerable subset of the HIV-positive population. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 67% |
| France | 1 | 17% |
| Canada | 1 | 17% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 83% |
| Scientists | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 32 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 5 | 16% |
| Researcher | 3 | 9% |
| Student > Master | 3 | 9% |
| Student > Doctoral Student | 2 | 6% |
| Student > Ph. D. Student | 2 | 6% |
| Other | 6 | 19% |
| Unknown | 11 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 25% |
| Social Sciences | 5 | 16% |
| Psychology | 2 | 6% |
| Immunology and Microbiology | 1 | 3% |
| Arts and Humanities | 1 | 3% |
| Other | 2 | 6% |
| Unknown | 13 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2017.
All research outputs
#14,573,452
of 25,330,051 outputs
Outputs from AIDS and Behavior
#1,844
of 3,680 outputs
Outputs of similar age
#157,378
of 321,147 outputs
Outputs of similar age from AIDS and Behavior
#31
of 82 outputs
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