ABSTRACT:
Food insecurity (FI), defined as limited access to adequate and safe food due to socioeconomic constraints¹, is a critical concern for people living with HIV (PLHIV), whose vulnerability is often amplified by stigma intersecting with race, gender, and sexual identity2-4. This cross-sectional study analyzed factors associated with FI among 332 PLHIV in Northeast Brazil. Data were collected via questionnaires in Salvador and Lauro de Freitas. Analysis using R software involved Pearson’s chi-square tests and logistic regression, with results expressed as odds ratios (OR) and 95% confidence intervals. The sample was predominantly Black/Mixed-race (90.1%), single (66.8%), homeowners (53.4%), LGBTQIAPN+ (60.1%), cisgender men (70.8%), had completed high school (39%), and had a monthly income between one and two minimum wages (41%). Dependence was found between the outcome variable FI and the independent variables: race, marital status, number of children, sexual identity, gender, socioeconomic status, education, household income, participation in the "Bolsa Família" program, and depression. The odds of FI were: 228% higher for Black individuals (OR=3.28, 95% CI: 1.27 – 9.44); 22% higher for each additional person in the household (OR=1.22, 95% CI: 1.04 – 1.45); 180% higher for socioeconomic classes C/D/E (OR=2.80, 95% CI: 1.34 – 6.04); 106% higher for basic education and illiteracy (OR=2.06, 95% CI: 1.11 – 3.87); 278% higher for moderate to severe depression (OR=3.78, 95% CI: 1.83 – 8.27); 174% higher for those who experienced gender discrimination (OR=2.74, 95% CI: 1.42 - 5.41); and 414% higher for those who experienced HIV/AIDS-related stigma (OR=5.14, 95% CI: 1.29 – 27.67). These results underscore profound intersecting inequalities, such as socioeconomic, racial, and gender-based, that significantly elevate the risk of food insecurity among PLHIV, highlighting the need for targeted, intersectional interventions.