Medicine and Health Sciences Commons^™

Evaluating A Technology-Mediated Hpv Vaccination Awareness Intervention: A Controlled, Quasi-Experimental, Mixed Methods Study, Heather M. Brandt, Beth Sundstrom, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Chelsea Larsen, Melissa Stansbury, Karen Magradey, Andrea Gibson, Delia Smith West

Faculty Publications

College-aged women and men are an important catch-up population for human papillomavirus (HPV) vaccination interventions. Limited research has explored technology-mediated HPV vaccination awareness interventions aimed at college students. The purpose was to evaluate a novel, technology-mediated, social media-based intervention to promote HPV vaccination among college students. A controlled, quasi-experimental, mixed methods study examined the feasibility of a technology-based intervention among two undergraduate classes ( = 58) at a public university in the southeastern United States of America. Classes were randomized to receive one of two cancer prevention programs (i.e., HPV vaccination (intervention) or healthy weight (control)). Both programs contained eight …

Information Uncertainty: A Correlate For Acute Stress Disorder During The Covid-19 Outbreak In China, Danhua Lin, Daniela B. Friedman Ph.D., Shan Qiao Ph.D., Cheuk Chi Tam, Xiaoyan Li, Xiaoming Li Ph.D.

Faculty Publications

Background: Individuals’ stress in responding to the current COVID-19 pandemic may be exacerbated by information uncertainty driven by inconsistent, unverified, and conflicting news from various sources. The current study aims to test if information uncertainty during the COVID-19 outbreak was related to acute stress disorder (ASD) over and above other psychosocial stressors.

Methods: An anonymous online survey was conducted with 7800 college students throughout China from January 31 through February 11, 2020. Existing scales were modified to measure ASD and six potential stressors including information uncertainty during the COVID-19 outbreak. Hierarchical regression analysis was conducted to assess the unique association …

Lc-Ms/Ms Quantification Of Nevirapine And Its Metabolites In Hair For Assessing Long-Term Adherence, Haoran Yang, Liuxi Chu, Yan Wu, Wei Wang, Jin Yang, Quan Zhang, Shan Qiao Ph.D., Xiaoming Li Ph. D., Zhiyong Shen, Yuejiao Zhou, Shuaifeng Liu, Huihua Deng

Faculty Publications

The adherence assessment based on the combination of nevirapine (NVP) and its two metabolites (2-hydroxynevirapine and 3-hydroxynevirapine) would more comprehensively and accurately reflect long-term adherence than that of a single prototype. This study aimed to develop a specific, sensitive and selective method for simultaneous detection of the three compounds in hair and explore whether there was consistency among the three compounds in assessing long-term adherence. Furthermore, 75 HIV-positive patients who were taking the NVP drug were randomly recruited and divided into two groups (high-and low-adherence group). All participants self-reported their days of oral drug administration per month and provided their …

External Stoma Diversion: A Palliative Measure For Peristomal Wound Healing In Resource-Limited Settings, Rachel W. Davis, Youmna A. Sherif, Catherine Anne Morrison

Faculty Publications

The provision of intestinal stoma care is challenging in austere settings due to limitations in surgical and wound care access as well as the high cost and sparsity of ostomy supplies. As a result, many surgical patients suffer from ostomy-related complications such as peristomal wounds and are unable to find relief for these complications from standard treatments and measures. This article describes the external stoma diversion, a cost-effective palliative surgical procedure that assists in the healing of peristomal wounds in resource-limited settings.

Parkindex: Validation And Application Of A Pragmatic Measure Of Park Access And Use, Andrew T. Kaczynski, S. Morgan Hughey, Ellen W. Stowe, Marilyn E. Wende, J. Aaron Hipp, Elizabeth L. Oliphant, Jasper Schipperijn

Faculty Publications

Composite metrics integrating park availability, features, and quality for a given address or neighborhood are lacking. The purposes of this study were to describe the validation, application, and demonstration of ParkIndex in four diverse communities. This study occurred in Fall 2018 in 128 census block groups within Seattle(WA), Brooklyn(NY), Raleigh(NC), and Greenville County(SC). All parks within a half-mile buffer were audited to calculate a composite park quality score, and select households provided data about use of proximal parks via an online, map-based survey. For each household, the number of parks, total park acreage, and average park quality score within one …

Association Between Appendicular Skeletal Muscle Index And Leukocyte Telomere Length In Adults: A Study From National Health And Nutrition Examination Survey (Nhanes) 1999-2002, Lingzhi Chen, Nitin Shivaooa, Xiuxun Dong, Jingjing Ming

Faculty Publications

Background A higher body mass index (BMI) is associated with shorter telomeres. The loss of muscle mass with aging is associated with adverse outcomes. The appendicular skeletal muscle index (ASMI) is currently used to quantify muscle mass. Objective We investigated the association of the ASMI with leukocyte telomere length in adult Americans. Methods This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). The telomere-to-single-copy gene ratio (T/S ratio) was converted to …

The Role Of Mental Health On The Relationship Between Food Insecurity And Immunologic Outcome Among People Living With Hiv In Guangxi, China, Cheng Chen, Xueying Yang, Chengbo Zeng, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

BACKGROUND

Previous studies showed that food insecurity could adversely affect clinical outcomes of people living with HIV (PLWH). The mental health pathways of such effects are suggested in existing literature, but empirical data are limited in resource-limited settings.

METHODS

This cross-sectional study aims to explore the role of depressive symptoms and anxiety on the association between food insecurity and CD4 counts among a sample of 2,987 PLWH in Guangxi, China. Path analysis was used to examine a hypothetical model and delta ztest was used to assess the indirect effects of food insecurity on CD4 counts through depressive symptoms and …

Development Of A Comprehensive Measure Of Organizational Readiness (Motivation × Capacity) For Implementation: A Study Protocol, Timothy J. Walker, Heather M. Brandt, Abraham Wandersman, Jonathan Scaccia, Andrea Lamont, Lauren Workman, Emanuelle Dias, Pamela M. Diamond, Derek W. Craig, Maria E. Fernandez

Faculty Publications

BACKGROUND: Organizational readiness is important for the implementation of evidence-based interventions. Currently, there is a critical need for a comprehensive, valid, reliable, and pragmatic measure of organizational readiness that can be used throughout the implementation process. This study aims to develop a readiness measure that can be used to support implementation in two critical public health settings: federally qualified health centers (FQHCs) and schools. The measure is informed by the Interactive Systems Framework for Dissemination and Implementation and R = MC heuristic (readiness = motivation × innovation-specific capacity × general capacity). The study aims are to adapt and further develop …

Building Capacity In Dissemination And Implementation Science: A Systematic Review Of The Academic Literature On Teaching And Training Initiatives, Rachel E. Davis, Danielle D'Lima

Faculty Publications

BACKGROUND: The field of dissemination and implementation (D&I) science has grown significantly over recent years. Alongside this, an increased demand for training in D&I from researchers and implementers has been seen. Research describing and evaluating D&I training opportunities, referred to here as 'capacity building initiatives' (CBIs), can help provide an understanding of different methods of training as well as training successes and challenges. However, to gain a more detailed understanding of the evidence-base and how D&I CBIs are being reported in publications, a field-wide examination of the academic literature is required. METHODS: Systematic review to identify the type and range …

Association Between Dietary Inflammatory Index And Type 2 Diabetes Mellitus In Xinjiang Uyghur Autonomous Region, China, Wenhui Fu, Hualian Pei, Nitin Shivaooa, James R. Hébert, Tao Luo, Tian Tian, Dilibaier Alimu, Zewen Zhang, Jianghong Dai

Faculty Publications

Background Diet and inflammation have both been studied in relation to type 2 diabetes mellitus (T2DM). The aim of this cross-sectional study was to examine the association between the Dietary Inflammatory Index (DII®) and T2DM. Methods Subjects were adults enrolled in the baseline study of the Xinjiang multi-ethnic natural population cohort and health follow-up study from January to May 2019. The study involved 5,105 subjects (58.7% men) between 35 and 74 years of age. The DII score was calculated from a data obtained via a food frequency questionnaire consisting of 127 food items. Results Logistic regression analyses were used to …

Terminal Logic Behavior And Strategic Defection Of Governmental Officials During Presidential Transitions In Guatemala: Implications For The Sustainability Of Food And Nutrition Security Policy, Jessica L. Escobar-Alegria, Edward A. Frongillo Jr., Christine E. Blake

Faculty Publications

Background: Presidents with no possibility of re-election overvalue far-future rewards and succumb to terminal logic behavior (TLB), responding to end-of-tenure legacy concerns despite political context. Government authorities perceiving the outgoing government is losing power at the end of term behave under the logic of strategic defection (SD), dissociating from the outgoing government once it is perceived powerless. In countries where re-election is impossible and government turnover and inconstant political parties are concerns, governmental officials at all levels may show TLB and SD during transitions that affect policy sustainability. Objectives: This study aimed to understand the context during presidential transitions that …

Parental Concerns And Uptake Of Childhood Vaccines In Rural Tanzania – A Mixed Methods Study, Lavanya Vasudevan, Joy Noel Baumgartner, Sara Moses, Esther Ngadaya, Sayoki Godfrey Mfinanga, Jan Ostermann

Faculty Publications

Background

Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.

Methods

Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. …

National Nutrition Strategies That Focus On Maternal, Infant, And Young Child Nutrition In Southeast Asia Do Not Consistently Align With Regional And International Recommendations, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Jennifer Cashin, Mellissa Withers, Roger Mathisen, Karin Lapping, Timothy D. Mastro, Edward A. Frongillo Jr.

Faculty Publications

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy …

African American Emerging Adult Perspectives On Unintended Pregnancy And Meeting Their Needs With Mobile Technology: Mixed Methods Qualitative Study, Lucy Annang Ingram, Crystal Stafford, Quentin Mccollum, Mckenzie Isreal

Faculty Publications

Background: In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs.

Objective: The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy …

Early Breastfeeding Practices Contribute To Exclusive Breastfeeding In Bangladesh, Vietnam And Ethiopia, Phuong Hong Nguyen, Sunny S. Kim, Lan Mai Tran, Purnima Menon, Edward A. Frongillo Jr.

Faculty Publications

Limited evidence exists on the complex relationship among interventions, early initiation of breastfeeding (EIBF), prelacteal feeding and exclusive breastfeeding (EBF). We examined whether early breastfeeding practices are associated with EBF and how much improving EIBF and non-prelacteal feeding contributes to increased prevalence of EBF. Survey data were collected in 2010 and 2014 as part of impact evaluations of Alive & Thrive (A&T) interventions to improve infant and young child feeding (IYCF) practices in Bangladesh, Vietnam and Ethiopia. Multivariable logistic regression analyses were used to examine effects of interventions and early breastfeeding practices on EBF. Structural equation modelling quantified the direct …

Elementary Classroom Teachers’ Self-Reported Use Of Movement Integration Products And Perceived Facilitators And Barriers Related To Product Use, Roddrick Dugger, Aaron Rafferty, Ethan Hunt, Michael W. Beets, Collin Andrew Webster, Brian Chen, Jeffrey Michael Rehling, Robert Glenn Weaver

Faculty Publications

Movement integration (MI) products are designed to provide children with physical activity during general education classroom time. The purpose of this study was to examine elementary classroom teachers’ self-reported use of MI products and subsequent perceptions of the facilitators of and barriers to MI product use. This study utilized a mixed-methods design. Elementary classroom teachers (n = 40) at four schools each tested four of six common MI products in their classroom for one week. Teachers completed a daily diary, documenting duration and frequency of product use. Following each product test, focus groups were conducted with teachers to assess facilitators …

Intermittent Pneumatic Compression For Venous Thromboembolism Prevention: A Systematic Review On Factors Affecting Adherence, Richard Greenall, Rachel E. Davis

Faculty Publications

OBJECTIVE: Venous thromboembolism (VTE) is a potentially fatal complication of hospitalisation. Intermittent pneumatic compression (IPC) is one approach to reducing the likelihood of a VTE. Adherence to IPC is known to be inadequate though the reasons for this remain unclear. This systematic review explores factors that affect adherence to IPC in the inpatient context. METHODS: Information sources-EMBASE, MEDLINE and PsycINFO were searched for literature between January 1960 and May 2019. Eligibility criteria-studies were included if they focused on inpatient care and examined factors affecting adherence to IPC devices. RESULTS: Included studies-a total of 20 out of 1476 studies were included. …

Building Implementation Science In Nutrition, Andrea M. Warren, Edward A. Frongillo Jr., Rahul Rawat

Faculty Publications

The field of nutrition has been investing in the development of many nutrition-specific and -sensitive policies and programs aimed at improving population-level malnutrition in all its forms. When there is a need to learn about a new system, programmatic context, or target population to understand how to effectively deploy an intervention to help improve nutrition, it is important to be able to ask a broad range of questions, both in topic and in scope. Our aim is to provide a simple and conceptually clear definition and principles to elaborate the science of implementation for nutrition to distinguish it from other …

Nanoparticles As Antibiotic-Delivery Vehicles (Advs) Overcome Resistance By Mrsa And Other Mdr Bacterial Pathogens: The Grenade Hypothesis, Amjed Alabresm, Yung Pin Chen, Savannah Wichter-Chandler, Jamie Lead, Brian C. Benicewicz

Faculty Publications

Objectives

The aim of this study was to examine how the concentrated delivery of less effective antibiotics, such as the Β-lactam penicillin G, by linkage to nanoparticles (NPs), could influence the killing efficiency against various pathogenic bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug resistant (MDR) strains.

Methods

The Β-lactam antibiotic penicillin G (PenG) was passively sorbed to fluorescent polystyrene NPs (20 nm) that were surface-functionalized with carboxylic acid (COO⁻-NPs) or sulfate groups (SO₄⁻-NPs) to form a PenG-NP complex. Antimicrobial activities of PenG-NPs were evaluated against Gram-negative and Gram-positive bacteria, including antibiotic resistant strains. …

A Method To Measure The Partitioning Coefficient Of Volatile Organic Compounds In Nanoparticles, Guiying Rao, Jeonghyeon Ahn, Abigail Evans, Michelle Casey, Eric P. Vejerano

Faculty Publications

The partitioning behavior of volatile organic compounds (VOCs) into nanoparticles is less studied compared to those of semivolatile organic compounds (SVOCs) because of the lower concentration of the VOCs that is expected to partition into particles. One challenge in measuring the accurate partition coefficient of VOCs is quantifying their low mass fraction that sorbed on nanoparticles and differentiating them from the high VOC concentrations present in the gas-phase. Systematically characterizing the partitioning coefficient at a specific environmental condition is also difficult when sampling in the field. During field sampling, thermal and non-thermal issues such as sampling artifacts and non-equilibrium conditions …

Men’S Vasectomy Knowledge, Attitudes, And Information-Seeking Behaviors In The Southern United States: Results From An Exploratory Survey, Ashley L. White, Rachel E. Davis, Deborah Lynn Billings Phd, Emily S. Mann

Faculty Publications

Vasectomy is one of the few options men have to manage their reproductive capacity and take on a more equitable role in pregnancy prevention. While the method is underused throughout the United States, the southern states have a lower prevalence rate compared to the rest of the country. Existing survey research does not assess what men know or think about the procedure as a means of understanding why this is the case. We created and conducted an exploratory survey to assess men’s knowledge, attitudes, and information-seeking behaviors about vasectomy in the Southern United States. We used targeted Facebook advertising to …

A Letter To Reconsider The Conditions For Testing Decontaminated N95 Respirators For Emergency Reuse To Address Shortage, Eric P. Vejerano, Jeonghyeon Ahn

Faculty Publications

The battle with COVID-19 pandemic has resulted in the shortage of personal protective equipment, particularly, N95 respirators. Healthcare workers who reused N95 respirators may resort to unproven methods of cleaning/sterilization that can severely compromise the respirators’ filtration efficiency. A recently issued guideline will test decontaminated N95 respirators against particles with a median diameter of 0.075 ± 0.020 µm at a flow rate of 85 L min–1. For emergency reuse, these conditions may be too stringent. N95 respirators tested at this flow rate had predicted efficiencies of < 69%, assuming complete degradation of their electrostatic coating. Experimental efficiencies were ~15% lower. For emergency reuse, we recommend to either adjust the flow rate closer to normal breathing, or the size of the test particle should reflect that of virus-laden respiratory aerosols (~> 0.5 µm). By reconsidering the test conditions, a substantial fraction of used/decontaminated respirators can …

Can Children Catch Up From The Consequences Of Undernourishment? Evidence From Child Linear Growth, Developmental Epigenetics, And Brain And Neurocognitive Development, Jef L. Leroy, Edward A. Frongillo Jr., Pragya Dewan, Maureen M. Black, Robert A. Waterland

Faculty Publications

Recovery from nutritionally induced height deficits continues to garner attention. The current literature on catch-up growth, however, has 2 important limitations: wide-ranging definitions of catch-up growth are used, and it remains unclear whether children can recover from the broader consequences of undernutrition. We addressed these shortcomings by reviewing the literature on the criteria for catch-up in linear growth and on the potential to recover from undernutrition early in life in 3 domains: linear growth, developmental epigenetics, and child brain and neurocognitive development. Four criteria must be met to demonstrate catch-up growth in height: after a period in which a growth-inhibiting …

Nutrient Timing: A Garage Door Of Opportunity?, Shawn M. Arent, Harry P. Cintineo, Bridget A. Mcfadden, Alexa Jenny Chandler, Michelle Angelique Arent

Faculty Publications

Nutrient timing involves manipulation of nutrient consumption at specific times in and around exercise bouts in an effort to improve performance, recovery, and adaptation. Its historical perspective centered on ingestion during exercise and grew to include pre- and post-training periods. As research continued, translational focus remained primarily on the impact and outcomes related to nutrient consumption during one specific time period to the exclusion of all others. Additionally, there seemed to be increasing emphasis on outcomes related to hypertrophy and strength at the expense of other potentially more impactful performance measures. As consumption of nutrients does not occur at only …

Linking Activity, Nutrition, And Child Health (Launch): Protocol For A Longitudinal Cohort Study Of Children As They Develop From Infancy To Preschool Age, Russell R. Pate, Edward A. Frongillo Jr., Kerry Cordan, Marsha Dowda, Alexander C. Mclain, Myriam E. Torres, William H. Brown, Agnes Bucko, Emily R. Shull

Faculty Publications

Background

Physical activity is known to provide important health benefits in children ages 3 years and above, but little is known about the effects of physical activity on health in very young children under age 3. LAUNCH (Linking Activity, Nutrition, and Child Health) is a study designed to expand the body of knowledge on development of physical activity behavior and associations between physical activity and other health characteristics as children transition from infancy to preschool age.

Methods

Physical activity and sedentary behavior will be measured objectively in young children over a period of 30 months. Each child will complete a …

Differential Relationships Between Waist Circumference And Cardiorespiratory Fitness Among People With And Without Type 2 Diabetes, Andrew Ortaglia, Samantha M. Mcdonald, Christina Supino, Michael D. Wirth, Xuem Sui, Matteo Bottai

Faculty Publications

Adults with type 2 diabetes mellitus tend to exhibit an increased level of central adiposity, augmenting their risk of further non-communicable diseases (NCDs). Importantly, consistent evidence demonstrates a significant, negative association between cardiorespiratory fitness (CRF) and waist circumference (WC). However, no previous studies have investigated differences in these CRF-related reductions in WC between adults with and without diabetes.

This study used data from the Aerobic Center for Longitudinal Studies, conducted between 1970 and 2006 among predominately Non-Hispanic White, middle-to-upper class adults in Texas. Quantile regression models were used to estimate CRF-related differences in WC between persons with and without diabetes. …

Effect Of Differences In Month And Location Of Measurement In Estimating Prevalence And Trend Of Wasting And Stunting In India In 2005-2006 And 2015-2016, Emily M. Madan, Edward A. Frongillo Jr., Sayeed Unisa, Laxmikant Dwivedi, Robert Johnston, Abner Daniel, Praween K. Agrawal, Sila Deb, Ajay Khera, Purnima Menon, Phuong H. Nguyen

Faculty Publications

Background: Child undernutrition in India remains widespread. Data from the National Family Health Survey 3 and 4 (NFHS-3 and NFHS-4) suggest that wasting prevalence has increased while stunting prevalence has declined. Objective: The objectives of this study were to do the following: ) describe wasting and stunting by month of measurement in India in children surveys, and ) test whether differences in the timing of anthropometric data collection and in states between survey years introduced bias in the comparison of estimates of wasting and stunting between NFHS-3 and NFHS-4. Methods: Data on wasting and stunting for 42,608 and 232,744 children …

Objective Church Environment Audits And Attendee Perceptions Of Healthy Eating And Physical Activity Supports Within The Church Setting, Marilyn E. Wende, Andrew T. Kaczynski, John A. Bernhart, Caroline G. Dunn, Sarah Wilcox

Faculty Publications

Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees’ perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was …

Association Of Multisetting Community Programs And Policies With Child Body Mass Index: The Healthy Communities Study, Vicki L. Collie-Akers, Stephen B. Fawcett, Jerry A. Schultz, Kandace K. Fleming, Rebecca E. Swinburne Romine, Lorrene D. Ritchie, Edward A. Frongillo Jr., S Sonia Arteaga

Faculty Publications

INTRODUCTION:

Expert opinion suggests that efforts to address childhood obesity should seek to transform the environments in which children operate. The objective of this study was to describe the extent to which multisetting programs and policies interact with community and child predictors and are associated with child body mass index (BMI) in the 130 US communities participating in the Healthy Communities Study.

METHODS:

For 2 years beginning in fall 2013, we collected data through key informant interviews on community programs and policies related to healthy weight among children that occurred in the 10 years before the interview. We characterized community …

Associations Between Food Insecurity And Psychotropic Medication Use Among Women Living With Hiv In The United States, Henry J. Whittle, William R. Wolfe, Lila A. Sheira, Edward A. Frongillo Jr., Kartika Palar, Daniel Merenstein, Tracey E. Wilson, Adebola Adedimeji, Mardge H. Cohen, Eryka L. Wentz, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

AIMS: Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS: We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary …