This study aimed: (1) to examine the sensitivity and specificity of the 2-item Hunger Vital Sign against the 18-item Household Food Security Survey Module (HFSSM) in identifying young children in food insecure households in emergency department and primary care sites and (2) to examine associations between food insecurity and adverse health conditions. We conducted cross-sectional surveys from 2009–2017 among 5039 caregivers of children age <48 months. We measured adverse child health by caregiver-reported perceived health, prior hospitalizations, and developmental risk (Parents’ Evaluation of Developmental Status). Analyses were conducted using covariate-adjusted logistic regression. Sensitivity and specificity of the Hunger Vital Sign against the HFSSM were 96.7% and 86.2%. Using the HFSSM, children in the emergency department had a 28% increase in the odds of experiencing food insecurity, compared to children in primary care, aOR = 1.28, 95% Confidence Interval (CI) = 1.08–1.52, p = 0.005. Using the Hunger Vital Sign, the increase was 26%, aOR = 1.26, 95% CI = 1.08–1.46, and p = 0.003. The odds of children’s adverse health conditions were significantly greater in food insecure households, compared to food secure households, using either HFSSM or the Hunger Vital Sign. Screening for food insecurity with the Hunger Vital Sign identifies children at risk for adverse health conditions in both primary care and emergency department sites, and can be used to connect families with resources to alleviate food insecurity.
To assess the variation in body dissatisfaction and depressive symptoms by weight status and the bi-directional relations between body dissatisfaction and depressive symptoms by weight status among Black adolescents. A sample of 153 Black adolescents aged 12–13 years, either overweight/obese (n = 57, 37%) or healthy weight (n = 96, 63%), were recruited and evaluated three times over two years (T1, T2 and T3). Measured weight and height were converted to age and sex-specific BMI z-score; body dissatisfaction was measured with silhouettes, and depressive symptoms were measured with the Beck Depression Inventory (BDI-I). Bidirectional relations were assessed with cross-lagged panel analyses, accounting for stability over time and contemporary correlations. Body dissatisfaction was higher among the overweight/obese group than the healthy weight group. No significant differences were found for depressive symptoms by weight status. Among the overweight/obese group, there were bidirectional relations: antecedent body dissatisfaction predicted subsequent depressive symptoms (T1-T2: β = 0.42, SE = 0.11, p<0.001; T2-T3: β = 0.36, SE = 0.09, p<0.001) and antecedent depressive symptoms predicted subsequent body dissatisfaction (T1-T2: β = 0.25, SE = 0.10, p = 0.012; T2-T3: β = 0.17, SE = 0.08, p = 0.045). Among the healthy weight group, there was no relation in either direction. Elevated body dissatisfaction among the overweight/obese group supports weight-based stigma as a stressor among Black adolescents. The bidirectional relations between body dissatisfaction and depressive symptoms among the overweight/obese group support the internalization of thinness idea and negative self-appraisal associated with depressive symptoms. Prevention of both body dissatisfaction and depressive symptoms may be mutually beneficial among Black adolescents with overweight/obesity.
Heated tobacco products (HTPs) have expanded globally. IQOS, a global HTP leader, was launched in Israel in 2016 and the US in 2019. To inform tobacco control efforts, it is critical to understand who is likely to use HTPs in different countries with distinct regulatory and marketing contexts. Thus, we conducted a cross-sectional survey among adult (ages 18–45) online panelists in the US (n = 1128) and Israel (n = 1094), oversampling tobacco users, in the fall of 2021, and used multivariable regression to identify correlates of (1) ever using IQOS; (2) past-month vs. former among ever users; and (3) interest in trying IQOS among never users. Among US adults, correlates of ever use included being Asian (aOR = 3.30) or Hispanic (aOR = 2.83) vs. White, and past-month use of cigarettes (aOR = 3.32), e-cigarettes (aOR = 2.67), and other tobacco (aOR = 3.34); in Israel, correlates included being younger (aOR = 0.97), male (aOR = 1.64), and cigarette (aOR = 4.01), e-cigarette (aOR = 1.92) and other tobacco use (aOR = 1.63). Among never users, correlates of greater interest included cigarette and e-cigarette use in the US (β = 0.57, β = 0.90) and Israel (β = 0.88, β = 0.92). IQOS use prevalence was low (US: 3.0%; Israel: 16.2%) but represented in vulnerable subpopulations (younger adults, racial/ethnic minorities).
15 April 2022 in JAIDS Journal of Acquired Immune Deficiency Syndromes
Background: The COVID-19 pandemic and its associated socioeconomic disruptions have disproportionally affected marginalized populations, including people living with HIV. Little is known about how the pandemic has affected populations experiencing multiple forms of stigma, discrimination, and violence, such as female sex workers (FSW) living with HIV. Methods: We conducted a cross-sectional survey between August and December 2020 among 187 FSW living with HIV in the Dominican Republic to examine the impact of COVID-19. Using multivariable logistic regression, we examined associations between COVID-19–related financial concerns, mental health, substance use, and partner abuse on engagement in HIV care and antiretroviral therapy adherence. We conducted mediation analysis to assess whether mental health challenges mediated the impact of partner abuse or substance use on HIV outcomes. Results: Most participants reported no income (72%) or a substantial decline in income (25%) since the COVID-19 pandemic. Approximately one-third of the participants (34%) reported COVID-19 had an impact on their HIV care and treatment. Greater COVID-19 financial concerns (adjusted odds ratio [aOR] = 1.14, 95% CI: 1.02 to 1.27), mental health challenges (aOR = 1.38, 95% CI: 1.06 to 1.79), and partner emotional abuse (aOR = 2.62, 95% CI: 1.01 to 6.79) were associated with higher odds of negatively affected HIV care, respectively. The relationship between increased emotional partner abuse and negatively affected HIV care was mediated by greater COVID-19–related mental health challenges. Conclusions: FSW living with HIV in the Dominican Republic have been significantly affected by the COVID-19 pandemic. Targeted interventions that address structural (financial security and partner abuse) and psychosocial (mental health) factors are needed to sustain HIV outcomes and well-being.