Untangling the Gordian knot of HIV, stress, and cognitive function via a mixed methods study of food insecurity

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Food insecurity (FI) impacts health via biological, psychological, behavioral, and social-structural pathways. As such, the study of FI in the etiology of poor health has helped illuminate synergistic and multidimensional pathways by which to intervene. For older women of color living with HIV, FI presents a multidimensional challenge and highlights a “Gordian knot” of interactions between aging and living with HIV. For example, HIV accelerates aging-related inflammation that impacts the central nervous system, leading to neurocognitive decline. Experiencing and overcoming FI is stressful, and for older women of color living with HIV, the stress of FI may exaggerate the age-related cognitive decline. In a seminal piece on the neurobiology of HIV, stress, and cognitive impairment, Valdez and colleagues (2016) argued that finding an underlying mechanism would require applying creative perspectives and methods. Moreover, because HIV, stress, and cognitive impairment are interrelated, breaking the cycle requires a multifaceted intervention. This application seeks to meet this challenge by using a theory-based, mixed methods approach to study FI as an underlying multidimensional factor in HIV, aging, stress, and neurocognitive decline among older women of color.