Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Debbie Humphries

Second Advisor

Kristina Talbert-Slagle



Background: Food insecurity is an issue of great concern among people living with HIV/AIDS (PLWHA). Food insecurity can lead to anxiety, and depression which is in turn associated with poor medication adherence. Food insecurity is a threat to the nutritional status of PLWHA. PLWHA already have a higher energy demand due to the presence of the virus. The lack of food intake can further compromise the immune system and encourage wasting. Because Food insecurity is such a concern among PLWHA, Caring Cuisine which is a program run by Aids Project New Haven in CT, delivers meals for clients who are homebound or unable to access food on their own. In this study we wanted to determine if Caring Cuisine clients had better clinical outcomes than non-participants after adjusting for confounding factors.

Methods: This was a five year retrospective study looking at clinical outcomes (Viral load and CD4) and intake form data (risk behavior, mental health, medication adherence, co-morbidities, HIV disease progression symptoms). It was designed as a matched case-control study where two controls (case-management clients of APNH, n=68) were matched to each case (n=34). Controls were matched to cases based on gender, HIV diagnosis date, age, and race.

Results: No difference was found in viral load suppression between Caring Cuisine and controls at t1. We found that there was a statistically different change in CD4 counts between females (n=48) and males (n=54) in the population (p=0.002). Males in Caring Cuisine had a much greater drop in CD4 counts between t0 and t1 than controls (p=0.071)

Conclusion: Further research needs to be done to determine how home-delivery meal programs affect clinical outcomes of PLWHA.


This is an Open Access Thesis.

Open Access

This Article is Open Access