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We examined the association of food insecurity with levels of ART concentrations in hair among women living with human immunodeficiency virus (WLHIV) in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed longitudinal data collected semiannually from 2013 through 2015 from the Women\u2019s Interagency HIV Study, a multisite, prospective, cohort study of WLHIV and controls not living with HIV. Our sample comprised 1944 person-visits from 677 WLHIV. Food insecurity was measured using the US Household Food Security Survey Module. ART concentrations in hair, an objective and validated measure of drug adherence and exposure, were measured using high-performance liquid chromatography with mass spectrometry detection for regimens that included darunavir, atazanavir, raltegravir, or dolutegravir. We conducted multiple 3-level linear regressions that accounted for repeated measures and the ART medication(s) taken at each visit, adjusting for sociodemographic and clinical characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At baseline, 67% of participants were virally suppressed and 35% reported food insecurity. In the base multivariable model, each 3-point increase in food insecurity was associated with 0.94-fold lower ART concentration in hair (95% confidence interval, 0.89 to 0.99). This effect remained unchanged after adjusting for self-reported adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Food insecurity was associated with lower ART concentrations in hair, suggesting that food insecurity may be associated with suboptimal ART adherence and\/or drug absorption. Interventions seeking to improve ART adherence among WLHIV should consider and address the role of food insecurity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz1007","type":"journal-article","created":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T03:27:37Z","timestamp":1570591657000},"page":"1517-1523","source":"Crossref","is-referenced-by-count":18,"title":["Food Insecurity Is Associated With Lower Levels of Antiretroviral Drug Concentrations in Hair Among a Cohort of Women Living With Human Immunodeficiency Virus in the United States"],"prefix":"10.1093","volume":"71","author":[{"given":"Anna M","family":"Leddy","sequence":"first","affiliation":[{"name":"Division of Prevention Science, Department of Medicine, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lila A","family":"Sheira","sequence":"additional","affiliation":[{"name":"Division of HIV, ID and Global Medicine, Department of Medicine, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bani","family":"Tamraz","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Sykes","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela D M","family":"Kashuba","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey E","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, State University of New York Downstate Health Sciences University, School of Public Health, Brooklyn, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adebola","family":"Adedimeji","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Merenstein","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Georgetown University Medical Center, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mardge H","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stroger Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eryka L","family":"Wentz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adaora A","family":"Adimora","sequence":"additional","affiliation":[{"name":"School of Medicine and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ighovwerha","family":"Ofotokun","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa R","family":"Metsch","sequence":"additional","affiliation":[{"name":"Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet M","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bacchetti","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California\u2013San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheri D","family":"Weiser","sequence":"additional","affiliation":[{"name":"Division of Prevention Science, Department of Medicine, University of California\u2013San Francisco, San Francisco, California, USA"},{"name":"Division of HIV, ID and Global Medicine, Department of Medicine, University of California\u2013San Francisco, San Francisco, California, 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