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AIDS Behav. 2019 Sep 19. doi: 10.1007/s10461-019-02676-5. [Epub ahead of print]

Perinatal Food Insecurity and Postpartum Psychosocial Stress are Positively Associated Among Kenyan Women of Mixed HIV Status.

Author information

1
Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA.
2
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
3
Department of Anthropology, Northwestern University, Evanston, IL, USA.
4
Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA.
5
Kenya Medical Research Institute, Nairobi, Kenya.
6
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA.
7
Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
8
Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
9
Department of Anthropology & Global Health; Faculty Fellow, Institute for Policy Research, Northwestern University, Evanston, IL, USA. sera.young@northwestern.edu.

Abstract

Stress and food insecurity (FI) are associated with poor perinatal and HIV outcomes. We hypothesized that FI would increase postpartum stress among women in Kenya, and that the impact would be greater in women with HIV. Among 371 pregnant women, we identified latent FI trajectories across the perinatal period, and estimated their association with postpartum stress. Stress metrics included the Perceived Stress Scale (PSS) and hair cortisol concentrations (HCC). We identified two FI trajectories: persistent moderate FI and persistent mild FI. Moderate FI (vs. mild) was associated with higher PSS; this association was stronger among HIV-negative women. We observed a trend towards higher HCC associated with moderate FI, which did not differ by HIV status. HCC and PSS were not correlated. In summary, moderate FI (vs. mild) was associated with increased stress. The lack of PSS-HCC correlation could reflect different physiological pathways. Interventions to mitigate FI could alleviate postpartum stress.

KEYWORDS:

Cortisol; First 1000 days; Food insecurity; HIV; Postpartum period; Pregnancy; Stress

PMID:
31538283
PMCID:
PMC7080582
[Available on 2021-03-19]
DOI:
10.1007/s10461-019-02676-5

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