The Impact of Food Insecurity on People Living with HIV in San Francisco

Food insecurity impacts more than one billion individuals globally and according to scholars, has been linked to a person’s HIV status (Bangsberg et al. 2011). More than 50% of housing insecure individuals living with HIV face food “insufficiency” as well as negative health effects (Bekele et al. 2015:1183). Scholars have found that food insecurity is widespread in San Francisco, California amongst housing insecure people living with HIV (Bangsberg et al. 2009). In order to further understand the impact of food insecurity on people living with HIV, I will discuss the following study called, "Food Insecurity, Chronic Illness, and Gentrification in the San Francisco Bay Area: An Example of Structural Violence in United States Public Policy." This study examines the lived effects and structural causes of food insecurity faced by a group of low-income individuals living with HIV/AIDS in the San Francisco Bay Area (Frongillo et al. 2015). 

"Food Insecurity, Chronic Illness, and Gentrification in the San Francisco Bay Area: An Example of Structural Violence in United States Public Policy"

Purpose of Study:

To examine the lived effects and structural causes of food insecurity faced by a group of low-income individuals living with HIV/AIDS in the San Francisco Bay Area.

Research Methods:

This study utilized quantitative methods. It conducted thirty-four semi-structured interviews with participants from April to June 2014 who had accessed food supplementation from a non-profit organization in the area. The transcripts were then coded and analyzed using content analysis, induction, and deduction.

Findings:

The study found that those facing food insecurity experienced hunger from a lack of food as well as lack of access to quality food, which created worries surrounding the health effects of a poor diet. Food was also acquired through socially deviant means including extended reliance on family members, friends and charities for food, stealing, sex, and the illicit sale of controlled substances. The study determined that a common cause of food insecurity was the combination of high rent payments (resulting from gentrification) and insufficient disability income. Authors of the study attribute these conditions to the implementation of urban policies conducive to gentrification and antiquated disability policies that hinder individuals’ means of subsistence.

Limitations:

Limitations of this study include that individuals who were chosen to participate had fared well in the past using the services provided by the non-profit food assistance program used in this study (Project Open Hand).

Implications for Policy Change:

Authors of this study emphasize that the food insecurity faced by these individuals is structural violence and advise that measures be taken to address food insecurity at a structural level, incorporating interventions, rather than simply addressing the issue of food insecurity.

References:

Bangsberg, David R., Edward A. Frongillo, Susan Kegeles, Margot B. Kushel, Kathleen
Ragland, and Sheri D. Weiser. 2009. “Food Insecurity Among Homeless and Marginally Housed Individuals Living with HIV/AIDS in San Francisco.” AIDS Behavior 13: 841–848.

Bangsberg, David R., Craig R. Cohen, Edward A. Frongillo, Abigail M. Hatcher, Margot B.
Kushel, Phyllis C Tien, Alexander C. Tsai, Sheri D. Weiser, and Sera L. Young. 2011. “Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS.” American Journal of Clinical Nutrition 94(6): 1729S-1739S.

Bekele, Tsegaye, Stephanie K.Y. Choi, Sarah Fielden, Jason Globerman, Saara Greene, Keith
Hambly, Stephen W. Hwang, J.J. Jay Koornstra, Doe O’Brien-Teengs, The Positive Spaces, Healthy Places Team, Sean B. Rourke, Michael Sobota, Ruthann Tucker, Glen Walker, and James Watson. 2015. “Food Insufficiency, Housing and Health-Related Quality of Life: Results from the Positive Spaces, Healthy Places Study.” AIDS Care 27(9): 1183-1190.

Frongillo, Edward A., Lee L. Hufstedler, Kartika Palar, Hilary K. Seligman, Sheri D. Weiser,
and Henry J. Whittle. 2015. “Food Insecurity, Chronic Illness, and Gentrification in the San Francisco Bay Area: An Example of Structural Violence in United States Public Policy.” Social Science & Medicine 143: 154-161.