Food Is Medicine for Human Immunodeficiency Virus: Improved Health and Hospitalizations in the Changing Health Through Food Support (CHEFS-HIV) Pragmatic Randomized Trial

Abstract

Abstract Background Policy support for “food is medicine”—medically tailored meals or groceries to improve health—is rapidly growing. No randomized trials have heretofore investigated the benefits of medically tailored food programs for people with human immunodeficiency virus (PWH). Methods The CHEFS-HIV pragmatic randomized trial included PWH who were clients of Project Open Hand (POH), a San Francisco–based nonprofit food organization. The intervention arm (n = 93) received comprehensive medically tailored meals, groceries, and nutritional education. Control participants (n = 98) received less intensive (POH “standard of care”) food services. Health, nutrition, and behavioral outcomes were assessed at baseline and 6 months later. Primary outcomes measured were viral nonsuppression and health-related quality of life. Mixed models estimated treatment effects as differences-in-differences between arms. Results The intervention arm had lower odds of hospitalization (odds ratio [OR], 0.11), food insecurity (OR, 0.23), depressive symptoms (OR, 0.32), antiretroviral therapy adherence <90% (OR, 0.18), and unprotected sex (OR, 0.18), as well as less fatty food consumption (β = −.170 servings/day) over 6 months, compared to the control arm. There was no difference between study arms in viral nonsuppression and health-related quality of life over 6 months. Conclusions A “food is medicine” intervention reduced hospitalizations and improved mental and physical health among PWH, despite no impact on viral suppression. Clinical Trials Registration NCT03191253.