HIV and Food Insecurity: A Syndemic Amid the COVID-19 Pandemic
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NOTES FROM THE FIELD
HIV and Food Insecurity: A Syndemic Amid the COVID‑19 Pandemic Taylor McLinden1 · Sofia Stover2 · Robert S. Hogg1,3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
On February 1, 2020, approximately 1 month after cases of pneumonia of unknown cause were detected in Wuhan, China [1], an editorial titled ‘The syndemic threat of food insecurity and HIV’ was published in The Lancet HIV [2]. In this publication, the authors conclude that advances in the fight against HIV must not be undermined by an experience as fundamental as food insecurity. In the following month, coronavirus disease 2019 (COVID-19), an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic by the World Health Organization [3]. While the authors of this editorial did not have the opportunity to reflect on the impacts of COVID-19 on the HIVfood insecurity syndemic, they discussed a ‘severe economic situation’ in Zimbabwe that ‘has left the healthcare system in a dire state, and spiralling inflation has left many without the money to pay for food let alone basic health services’ [2]. While this statement reflects a difficult reality for people living with HIV (PLWH) in Zimbabwe, it is anticipated that there will be challenging economic situations ahead, for many countries, as a result of the COVID-19 pandemic [4, 5]. As such, it is not surprising that food insecurity has already been highlighted in a syndemic conceptualization of HIV and COVID-19 among PLWH [6]. In addition to the health [7] and social [8, 9] impacts, the economic impacts of COVID-19, at both the micro- and macro-levels, have been unprecedented: long-standing businesses are shuttering [4, 5], unemployment levels are climbing [10], and some countries are now reporting shrinking economies in Quarter 1, 2020 for the first time in more than
* Taylor McLinden [email protected] 1
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
2
Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
3
Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
a decade [11–13]. For example, in March 2020, Statistics Canada reported that more than one million jobs were lost in Canada, the worst single-month change on record [14]. Similarly, a recent United States Department of Labor News Release (April 16, 2020) highlighted that several million Americans are now filing for unemployment insurance each week [15]. While it has yet to be quantified, the experience of food insecurity, along with its consequences, will potentially be exacerbated for vulnerable populations, including PLWH, during these turbulent times.
Food Security: A Basic Human Right According to the Universal Declaration of Human Rights [16], access to adequate food is considered a basic human right. An intrinsic precursor to this right is food security. Lack of food security, or food insecurity, exists ‘whenever the availability of nutritionally adequate and safe foods or the
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