{"doi":"10.1093/ofid/ofad360","title":"Food Insecurity Is Associated With Low Tenofovir Diphosphate in Dried Blood Spots in South African Persons With HIV","abstract":"Abstract Background Food insecurity has been linked to suboptimal antiretroviral therapy (ART) adherence in persons with HIV (PWH). This association has not been evaluated using tenofovir diphosphate (TFV-DP) in dried blood spots (DBSs), a biomarker of cumulative ART adherence and exposure. Methods Within a prospective South African cohort of treatment-naive PWH initiating ART, a subset of participants with measured TFV-DP in DBS values was assessed for food insecurity status. Bivariate and multivariate median-based regression analysis compared the association between food insecurity and TFV-DP concentrations in DBSs adjusting for age, sex, ethnicity, medication possession ratio (MPR), and estimated glomerular filtration rate. Results Drug concentrations were available for 285 study participants. Overall, 62 (22%) PWH reported worrying about food insecurity and 44 (15%) reported not having enough food to eat in the last month. The crude median concentrations of TFV-DP in DBSs differed significantly between those who expressed food insecurity worry versus those who did not (599 [interquartile range {IQR}, 417–783] fmol/punch vs 716 [IQR, 453–957] fmol/punch; P = .032). In adjusted median-based regression, those with food insecurity worry had concentrations of TFV-DP that were 155 (95% confidence interval, −275 to −35; P = .012) fmol/punch lower than those who did not report food insecurity worry. Age and MPR remained significantly associated with TFV-DP. Conclusions In this study, food insecurity worry is associated with lower TFV-DP concentrations in South African PWH. This highlights the role of food insecurity as a social determinant of HIV outcomes including ART failure and resistance.","journal":"Open Forum Infectious Diseases","year":2023,"id":375137,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9188,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1137813,"name":"Jonathan A Edwards","orcid":null,"position":1,"is_corresponding":false},{"id":485175,"name":"Chad Robichaux","orcid":"0009-0002-8403-5499","position":2,"is_corresponding":false},{"id":441741,"name":"Jaysingh Brijkumar","orcid":"0000-0002-3511-2112","position":3,"is_corresponding":false},{"id":1137814,"name":"Mahomed-Yunus S. Moosa","orcid":null,"position":4,"is_corresponding":false},{"id":382869,"name":"Igho Ofotokun","orcid":"0000-0003-2735-1903","position":5,"is_corresponding":false},{"id":441742,"name":"Brent A. Johnson","orcid":"0000-0001-5665-8598","position":6,"is_corresponding":false},{"id":589300,"name":"Selvan Pillay","orcid":"0000-0002-3889-3989","position":7,"is_corresponding":false},{"id":999326,"name":"Melendhran Pillay","orcid":"0000-0002-5570-1010","position":8,"is_corresponding":false},{"id":433641,"name":"Pravi Moodley","orcid":"0000-0002-9946-8783","position":9,"is_corresponding":false},{"id":22017,"name":"Yan V. Sun","orcid":"0000-0002-2838-1824","position":10,"is_corresponding":false},{"id":236695,"name":"Chang Liu","orcid":"0000-0002-8918-7224","position":11,"is_corresponding":false},{"id":1012408,"name":"Matthew R. Dudgeon","orcid":"0000-0002-6582-4452","position":12,"is_corresponding":false},{"id":457755,"name":"Claudia L. Ordoñez","orcid":null,"position":13,"is_corresponding":false},{"id":69665,"name":"Daniel R. Kuritzkes","orcid":"0000-0001-6196-5883","position":14,"is_corresponding":false},{"id":442723,"name":"Henry Sunpath","orcid":null,"position":15,"is_corresponding":false},{"id":395981,"name":"Mary Morrow","orcid":"0000-0002-2115-4864","position":16,"is_corresponding":false},{"id":279022,"name":"Peter L. Anderson","orcid":"0000-0002-1200-8494","position":17,"is_corresponding":false},{"id":396717,"name":"Lucas Ellison","orcid":null,"position":18,"is_corresponding":false},{"id":280276,"name":"Lane R. Bushman","orcid":null,"position":19,"is_corresponding":false},{"id":104965,"name":"Vincent C. Marconi","orcid":"0000-0001-8409-4689","position":20,"is_corresponding":false},{"id":395985,"name":"José Castillo‐Mancilla","orcid":"0000-0003-1242-1745","position":21,"is_corresponding":false},{"id":1137812,"name":"Molly L Hirsh","orcid":null,"position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-19T01:16:19.336238Z","pmid":"37469618","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}