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PubMed2026

A systematic review of qualitative research on HIV and food insecurity in high-income countries.

OBJECTIVES: Food insecurity leads to adverse health outcomes in people living with HIV, including obesity, poor mental health and viral non-suppression. Qualitative studies in low- and middle-income countries have described the impact of food insecurity on medication adherence. However, limited qualitative research exists on the lived experiences of food insecurity among people living with HIV in high-income countries (HICs). We aimed to synthesize qualitative literature on food insecurity among people living with HIV in HICs. DESIGN: Systematic review and textual narrative synthesis. METHODS: We searched MEDLINE, CINAHL, Scopus, Embase, and PsycINFO, extracting data from included articles on a standardized form in Covidence. We synthesized literature using a textual narrative approach. We conducted quality appraisal (Critical Appraisal Skills Programme Qualitative Studies Checklist) and graded certainty of findings (GRADE-CERQual). RESULTS: We reviewed 2772 articles, reduced to 940 after deduplication, with 12 articles included after full text screening. Included articles reported on studies conducted in the United States ( n  = 7), and Canada ( n  = 5). We identified three key themes, each with their own sub-themes: the role of structural inequalities in shaping and navigating food insecurity; the impacts of food insecurity on health and wellbeing; and the labour of acquiring of food. CONCLUSIONS: Our review highlights the syndemic nature of food insecurity and HIV; intersecting experiences of multiple structural hardships constellate and interact synergistically to amplify poor health outcomes. Interventions should address the multiple and reinforcing social and structural conditions that shape food insecurity among people living with HIV.

Humans↗

PubMed2025

A study of the link between food-water insecurities and self-reported psychotic experiences among young adults in Gaza Strip: What role does social support play under conditions of war and extreme suffering?

BACKGROUND: The war in Gaza, coupled with severe restrictions on humanitarian access and assistance, have led to a rapid and large-scale exacerbation of food insecurity (FI) and water insecurity (WI) in Gaza, which can cause a myriad of deleterious effects on both physical and mental health. Previous evidence suggests that environmental stressors (such as FI and WI), coupled with lack of support, can compromise coping ability and trigger psychosis. Elucidation of these pathways can inform efforts to reduce the incidence of psychosis in war settings in particular, and in global communities more generally. This study aimed to assess the mediating role of social support on the association between food-water insecurities and psychotic experiences (PEs). METHODS: This study was carried-out over a period of one month (September 2024) by using a free online form builder. Data were collected at a single time point using snowball sampling. A total of 476 adults aged 18–35 years and living in Gaza at the time of the survey took part in this study. The Prodromal Questionnaire- Brief, the Food Insecurity Experience Scale, the Four-Item Household Water Insecurity Experiences Scale, and the Single Item Measure of Social Supports have been administered to participants. RESULTS: A total of 110 participants (23.1%) reported low tangible social support (i.e., having no or 1 person in the social support network), 27.3% were classified as moderately-to-severely food insecure and 41% were categorized as water-insecure. The mediation analysis was adjusted for the following covariates: marital status, living arrangement and age. Higher food-water insecurity experiences were significantly associated with lower social support. Higher food-water insecurity experiences were also significantly associated with higher PEs. Higher social support was significantly associated with lower PEs. The results of the mediation analysis showed that social support mediated the link of FI (indirect effect: Beta = 0.06; Boot SE = 0.03; Boot CI 0.01; 0.12) and WI (indirect effect: Beta = 0.04; Boot SE = 0.02; Boot CI 0.01; 0.08) to PEs. CONCLUSION: Our findings support the case for bolstering social support networks in war-affected communities facing survival challenges such as FI and WI. This study points to the urgent need for increased food aid and improved water supplies in the short term, and sustainable food and water systems in the long term, to support mental health. In times of war, mental health prevention and interventions strategies might do well to increase social support and resources in order to help buffer such intense environmental stressors and prevent the emergence of psychosis. CLINICAL TRIAL NUMBER: Not applicable.

Humans↗

PubMed2026

Metabolic Dysfunction-Associated Steatotic Liver Disease Is Associated With Adverse Social Factors: An Analysis Using All of Us.

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is progressive, with estimated global prevalence exceeding 30%. Social determinants of health (SDOH) may impact MASLD risk and progression. However, this has not been fully characterized. We harnessed the power of the All of Us Research Program (AoU) dataset to conduct a comprehensive analysis examining the association between various SDOH and MASLD. METHODS: We conducted a retrospective cross-sectional analysis of the AoU database. We identified participants with MASLD using ICD-9 and -10 codes and excluded individuals with other chronic liver diseases or self-reported heavy alcohol use. Healthy control participants were devoid of chronic liver diseases, heavy alcohol use, and comorbidities associated with MASLD if obese. We examined SDOH by combining relevant questions from various AoU surveys and conducted univariate and multivariate logistic regression to examine the association between various SDOH and MASLD. RESULTS: After matching cases to controls by age and race/ethnicity, the sample of 57,895 participants had a 1:3 case to control ratio; 16,666 had complete SDOH survey data (MASLD to controls, 1:3.4). Compared to controls, individuals with MASLD were more likely to have less than a high school education (10.7% vs 9.7%; P < .001) and annual income ≤$35,000 (42.4% vs 34.3%; P < .001). Compared to controls, participants with MASLD had significantly higher levels of social isolation, neighborhood disorder, perceived stress, food insecurity, and transportation insecurity (P < .001 for all). CONCLUSION: The study identified significant associations between MASLD and multiple SDOH. Future studies should investigate how SDOH interact to drive MASLD risk and progression.

All of Us↗

PubMed1978

Anorexia nervosa in boys.

The literature on primary anorexia nervosa in the male is reviewed and the case histories of 3 new patients are reported. Most surveys comment on the rarity of the syndrome in the male, with the sex ratio in the range of 1 in 10 to 1 in 20. The patients reported here had certain features in common. All the mothers and fathers were overweight, but obesity was marked only in the fathers, who also showed moderate to severe degrees of alcoholism. The mothers were oversensitive, insecure individuals, and the marriages suffered in proportion to the severity of the husband's alcoholism. Preoccupation with food was observed on home visits. There was overt mutual hostility between each father and anorexic son; the boys showed pronounced obsessional traits in their personalities. Dieting in order to ameliorate real or feared obesity was a first step in the development of the syndrome in each boy. In the past 3 years an equal number of boys and girls (new patients) have been referred for treatment in the psychiatric unit. Speculative reasons for this are discussed.

Adolescent↗

PubMed2026

Variations in the viral hepatitis C prevalence and treatment status by material hardship and cumulative risk among people who inject drugs.

People who inject drugs (PWID) are disproportionately impacted by viral hepatitis C (HCV). Among PWID, homelessness, poverty, and material insecurity elevate infectious disease risk. We hypothesized a positive association between material hardship (difficulty accessing basic needs) and lifetime diagnosis of HCV, and a negative association between cumulative risk (material hardship and years since first injection) and HCV treatment. From 2021-22, we conducted a survey among community-recruited PWID that included items on HCV outcomes, material hardship (a sum score of usually (4) to never (1) having difficulty finding food, clothing, shelter, restrooms, and showers in the past 3 months), and years since injection drug use initiation. We developed a latent variable, cumulative risk, by combining individual scores of material hardship indicators and years since first injection drug use. Among our sample of PWID (n = 471), 246 (53%) participants reported lifetime HCV diagnosis and 27% of those who tested positive for HCV reported ever or current treatment (n = 67). In modified-Poisson regression, a one-unit increase in material hardship score was associated with a 3% (OR: 1.03, 95% CI: 1.01%, 1.05%) increase in odds of HCV diagnosis. In latent modeling, among PWID testing positive for HCV, a one-unit increase in cumulative risk score was associated with a 0.28 (OR: -0.28, 95% CI: -0.50, -0.06), decrease in the Z-score odds of receiving HCV treatment. Findings emphasize structural interventions to strengthen material security and co-delivering basic needs with health services to improve HCV-related outcomes among PWID.

HCV↗