{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:56:16Z","timestamp":1760147776108,"version":"3.40.5"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980020002694_as1\"><jats:title>Objective:<\/jats:title><jats:p>The current study aimed to understand how moderate and severe food-insecure people living with HIV (PLHIV) in the Dominican Republic perceive a healthy diet and explore facilitators and barriers to engaging in healthy dietary behaviours as a means of HIV self-management.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980020002694_as2\"><jats:title>Design:<\/jats:title><jats:p>We conducted semi-structured interviews with PLHIV. We generated codes on food insecurity among PLHIV and used content analysis to organise codes for constant comparison between and within participants.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980020002694_as3\"><jats:title>Setting:<\/jats:title><jats:p>Two urban HIV clinics in the Dominican Republic.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980020002694_as4\"><jats:title>Participants:<\/jats:title><jats:p>Thirty-two PLHIV participated in the interviews.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980020002694_as5\"><jats:title>Results:<\/jats:title><jats:p>Factors that contributed to dietary behaviours include individual factors, such as knowledge of nutrition, views and attitudes on healthy dietary behaviours, beliefs about dietary needs for PLHIV and diet functionality. Interpersonal factors, including assistance from family and peers in providing food or funds, were deemed critical along with community and organisational factors, such as food assistance from HIV clinics, accessibility to a variety of food store types and the availability of diverse food options at food stores. Policy-level factors that influenced dietary behaviours were contingent on respondents\u2019 participation in the labour market (i.e. whether they were employed) and consistent access to government assistance. Food insecurity influenced these factors through unpredictability and a lack of control.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980020002694_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>PLHIV who experience food insecurity face various barriers to engaging in healthy dietary behaviours. Their diets are influenced at multiple levels of influence ranging from individual to structural, requiring multi-level interventions that can address these factors concurrently.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980020002694","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T09:40:03Z","timestamp":1598262003000},"page":"3018-3027","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Perceptions and determinants of healthy eating for people with HIV in the Dominican Republic who experience food insecurity"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-6957","authenticated-orcid":false,"given":"Deshira D","family":"Wallace","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise D","family":"Pay\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amarilis","family":"Then-Paulino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Armenta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Altagracia","family":"Fulcar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram\u00f3n","family":"Acevedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-6024","authenticated-orcid":false,"given":"Kathryn P","family":"Derose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,8,24]]},"reference":[{"volume-title":"Poverty and Equity Brief: Dominican Republic","year":"2020","key":"S1368980020002694_ref26"},{"key":"S1368980020002694_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-016-0129-7"},{"key":"S1368980020002694_ref12","unstructured":"12. The Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2018) Country Factsheets Dominican Republic, 2017. Geneva, Switzerland: The Joint Nations Programme on HIV\/AIDS."},{"key":"S1368980020002694_ref35","doi-asserted-by":"publisher","DOI":"10.1177\/2325957413514630"},{"volume-title":"Content Analysis: An Introduction to Its Methodology","year":"1989","author":"Klaus","key":"S1368980020002694_ref22"},{"key":"S1368980020002694_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2017.07.002"},{"key":"S1368980020002694_ref19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0181568"},{"key":"S1368980020002694_ref32","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2017.29.5.475"},{"key":"S1368980020002694_ref4","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.012070"},{"key":"S1368980020002694_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2013.10.001"},{"key":"S1368980020002694_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200106150-00015"},{"key":"S1368980020002694_ref13","unstructured":"13. Central Intelligence Agency (CIA) (2018) The World Factbook: Dominican Republic. Langley, Virginia: Central Intelligence Agency."},{"key":"S1368980020002694_ref29","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980007246725"},{"volume-title":"Pil\u00f3n de al Alimentaci\u00f3n y Nutrici\u00f3n Rep\u00fablica Dominicana: Gu\u00edas Alimentarias Basadas en Alimentos de la Rep\u00fablica Dominicana [The Mortar of Food and Nutrition: Nutritional Guide Based on Foods of the Dominican Republic].","year":"2009","key":"S1368980020002694_ref16"},{"key":"S1368980020002694_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.02.033"},{"key":"S1368980020002694_ref21","doi-asserted-by":"publisher","DOI":"10.7748\/nr.4.1.81.s9"},{"key":"S1368980020002694_ref34","doi-asserted-by":"publisher","DOI":"10.1177\/2325958219849042"},{"key":"S1368980020002694_ref18","unstructured":"18. Escala Latinoamericana y Caribe\u00f1a de Seguridad Alimentaria (2012) Escala Latinoamericana y Caribe\u00f1a de Seguridad Alimentaria (ELCSA): manual de uso y aplicaciones [Latin American and Caribbean Scale on Food Insecurity (ELCSA): Manual on scale use and application]. Comit\u00e9 Cient\u00edfico de la ELCSA. 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Fundaci\u00f3n Solidaridad (2018) Solidaridad [Solidarity]. Santo Domingo, Dominican Republic: Fundaci\u00f3n Solidaridad."},{"key":"S1368980020002694_ref24","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"volume-title":"Dedoose: Web Application for Managing, Analyzing, and Presenting Qualitative and Mixed Method Research Data","year":"2016","key":"S1368980020002694_ref20"},{"key":"S1368980020002694_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s40795-015-0017-7"},{"key":"S1368980020002694_ref15","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2017.1348597"},{"key":"S1368980020002694_ref8","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2014.983041"}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1368980020002694","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T10:58:05Z","timestamp":1623841085000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1368980020002694\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,24]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["S1368980020002694"],"URL":"https:\/\/doi.org\/10.1017\/s1368980020002694","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"type":"print","value":"1368-9800"},{"type":"electronic","value":"1475-2727"}],"subject":[],"published":{"date-parts":[[2020,8,24]]},"assertion":[{"value":"\u00a9 The Author(s), 2020. 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