Food insecurity in pediatric HIV: understanding a critical challenge in the United States.

Advancing the well-being of individuals living with HIV necessitates attention to social determinants of health, including food insecurity. Through a clinical and community-based needs assessment, we aimed to gain insight into experiences of food insecurity among patients receiving care at a large pediatric HIV outpatient clinic in the Southeastern United States. We adopted a multimodal assessment approach involving a literature review, community profiling, key informant interviews, focus group discussions with staff, patients and parents and a community stakeholder advisory meeting. Our needs assessment demonstrates that food insecurity is an important aspect of the lived experience of children, adolescents and young adults living with HIV. Clinical staff agreed that food insecurity screening should be incorporated into the patient care workflow but ideally only in concert with providing resources that meet their needs. We formulated a recommendation matrix for addressing food insecurity based on priority importance and feasibility. Collaborative relationships between healthcare practitioners and leaders, community-based organizations and local and federal funding sources are vital for enhancing patients' access to sustainable, reliable solutions to this fundamental determinant of health. Our approach provides a tested model for other clinics seeking to identify and alleviate food insecurity among patients.

Psychological well-being in persons receiving HIV-related mental health services: the role of personal meaning in a stress and coping model.

OBJECTIVE: This investigation examined the association of personal meaning to psychological well-being in adults living with HIV/AIDS receiving mental health services. Personal meaning refers to a framework for delineating the purposes and goals that make life worth living and for evaluating the degree to which these purposes and goals are being fulfilled. Personal meaning was hypothesized to be positively associated with psychological well-being and to contribute independently to the variance in psychological well-being over and above social support, dispositional optimism and coping behavior. METHOD: With the use of a cross-sectional design, a set of self-report measures were completed by 132 adults living with HIV disease at the time of their initial mental health services evaluation. Data were analyzed using correlation and regression techniques. RESULTS: Personal meaning was positively associated with psychological well-being, although it did not contribute significantly to the variance in well-being over and above social support, optimism and coping behavior in a multifactorial regression model. Post hoc analysis showed partial mediation by optimism of the association between personal meaning and well-being. CONCLUSIONS: Personal meaning should be considered along with other psychological and behavioral coping factors in understanding and intervening clinically with individuals living with HIV disease and co-occurring psychiatric concerns.