While it may be common knowledge that proper nutrition is essential in coping with health issues, many people living with HIV are at heightened risks for not being able to regularly access food.
To this point, a national study, funded by the Canadian Institutes of Health Research, examined how food insecurity affected health outcomes in populations in Quebec, Ontario, and British Columbia.
The B.C. component of the study, published in 2016, found that 72 percent of B.C. participants with HIV were food insecure, compared to eight percent of the overall Canadian population.
Difficulties in obtaining food were compounded by factors such as unemployment, lower incomes, housing costs, criminal records, or substance use.
In comparison, food-secure participants with HIV had 78 percent stronger immune systems, had 70 percent less depression symptoms and were 21 percent higher on mental-health measures, and were 22 percent more likely to take their prescribed medications.
Among the recommendations the study suggested to address these issues is the integration of nutrition and food-security assessments in HIV and harm-reduction strategies.
While there have been longterm food-oriented organizations in Vancouver such as the volunteer-run A Loving Spoonful, which has provided free meals to people with HIV since 1989, a new initiative in Vancouver is combining nutrition with therapy.
At a press conference held by the Dr. Peter Centre today (June 1) in Vancouver's West End, executive director Scott Elliott announced that his non-profit HIV healthcare organization has received a $100,000 grant from the HIV research and treatment company ViiV Healthcare to continue their food-security Evening Program for the next two years.
As the only program of its kind in Canada, it provides support and nutrition for aging gay, bisexual, or other men who have sex with men (MSM) who are living with HIV and are over 50 years old.
A pilot program was successfully run over the past year, offering an evening of therapy, healthcare, and a nutrient-dense meal. Therapeutic elements include group mindfulness and relaxation activities, exercise at the fitness centre, art and music therapy (including weaving, drawing, ceramics, or learning to play musical instruments), and counselling.
Counsellor Randy Miller, involved in pilot project, explained that it operates as a drop-in open every Wednesday from 4 to 6 p.m. He said they have almost 30 participants, with a core group of 12 to 15 regular attendees.
With an emphasis on well-balanced nutrition in all meals, Miller said that their chefs have served dishes such as chicken stew with vegetables over brown rice, a mix of prawn and seafood over rice, or chicken parmesan.
"The goal is really to help minimize isolation, increase social connection, and minimize food insecurities," he said. He added that the simple act of eating a meal together with others can be particularly powerful for some individuals. "That really evokes a lot of emotion for people who lost a lot of folks in their lives, who have different issues around taking food as a group."
Miller cited the perspective of a participant who felt that the group offers hope, promotes positive attitudes, and provides role models in approaching life with HIV. Elliott cited another participant who said that the support helps individuals to cope with the psychological challenges of uncertain future health, fears of impending illness or death, and HIV stigma and isolation, all of which are compounded by the complications of aging.
Such an approach is responding to how the success of medical advances has brought about new, unexplored issues to deal with.
"With a new generation of people living 30 and 40 years on medication…we're seeing unique challenges that are coming up that we've never had," Elliott said. He went on to explain that people who have been in the program since the onset of the disease 30 years ago, many of whom were involved in the struggles to gain access to medication, are now at a new stage of treatment, thus necessitating different types of support.
Elliott said that although it is a unique program in Canada, they'd like to see the program replicated.
"We're already in discussion with other organizations in Vancouver and we're looking at how can we get organizations across the province to learn from the ability that we've had," he said.
The grant announcement arrives at a time when many HIV organizations are facing funding cuts or fundraising challenges. For instance, the Public Health Agency of Canada cut $400,000, or 46 percent of funding for the Vancouver-based Canadian Aboriginal AIDS Network, effective as April 1.
A food-related HIV program contending with underfunding is the AIDS Vancouver Grocery Program, which has operated since the late 1980s, when it began informally with handing out bags of groceries from their alley loading bay. The program now supplies approximately 1,200 people with over 16,000 grocery bags each year.
However, the program is only open two days a week every two weeks (and holds additional dates for women only). In a phone interview, AIDS Vancouver executive director Brian Chittock told the Georgia Straight that it is their most important program but lacks sufficient funding.
Although Vancouver Coastal Health covers their operating expenses, he said funding for food purchases come from donations and fundraising, and supporters such as the B.C. Gaming Commission, the Shooting Stars Foundation, and the Elizabeth Taylor AIDS Foundation. The program also provides groceries to partners such as the Positive Women's Network, the Portland Hotel Society, the Vancouver National Health Society, and A Loving Spoonful.
Chittock said he would like to double the program's current operating level, as many clients go without food between their program's opening hours.
Other recommendations given by the CIHR food-security study include further research on the how food insecurity affects antiretroviral treatment for people with HIV, and increasing knowledge and awareness about nutrition for people with HIV.