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Food insecurity FI is emerging as an important barrier to adherence to care and treatment recommendations for people living with HIV PLHIV , but this relationship has not been comprehensively examined. We identified a number of mechanisms to explain how food insecurity and ART non-adherence may be causally linked, including the exacerbation of hunger or ART side effects in the absence of adequate food and competing resource demands.
Indeed, ART non-adherence is the most consistent predictor of incomplete viral load suppression, development of drug resistance, and progression to AIDS and death. Thus, identifying the many barriers to initiating and sustaining ART is critical to ensure its individual and public health benefits. Food insecurity, when people do not have physical, social, and economic access to sufficient safe and nutritious foods that meet their dietary needs and food preferences for an active and healthy life, 10 is emerging as an important barrier to adherence to care and treatment recommendations for people living with HIV and AIDS PLHIV.
To date, most research has examined associations between food insecurity and adherence to ART among the general adult HIV-infected population. However, burgeoning data also suggest that food insecurity may negatively impact adherence to care and treatment recommendations among specific sub-populations, such as HIV-infected pregnant women and their HIV-exposed infants as well as children and adolescents living with HIV infection.
Thus, the purpose of this paper is to provide an overview of the relationship between food insecurity and adherence to HIV care and treatment recommendations for PLHIV, and to review the evidence on potential pathways by which food insecurity may adversely impact adherence to HIV care recommendations among three distinct populations: 1 general adult populations of PLHIV, 2 HIV-infected pregnant women and their HIV-exposed infants, and 3 child and adolescent populations of PLHIV.
We conducted a narrative review of the state of the evidence on food insecurity and ART adherence. We identified key articles in the qualitative and quantitative literature that illustrate current findings on this relationship. Relevant English language articles were reviewed for possible inclusion. We also identified sources from the bibliographies of included papers and conference presentations related to food insecurity and ART adherence.
Food insecurity, while usually assessed at the household level, has negative health impacts at the individual level and is strongly linked with structural factors at the community level such as food availability and prices.
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Denmark proper, [N 2] which is the southernmost of the Scandinavian countries, consists of a peninsula, Jutland , and an archipelago of named islands ,  with the largest being Zealand , Funen and the North Jutlandic Island. The islands are characterised by flat, arable land and sandy coasts, low elevation and a temperate climate. Denmark lies southwest of Sweden and south of Norway , [N 11] and is bordered to the south by Germany.
The Kingdom of Denmark is constitutionally a unitary state comprising Denmark proper and the two autonomous territories  in the North Atlantic Ocean : the Faroe Islands and Greenland. The unified kingdom of Denmark emerged in the 8th century as a proficient seafaring nation in the struggle for control of the Baltic Sea. The areas of Denmark and Norway remained under the same monarch until , Denmark—Norway.
Beginning in the 17th century, there were several devastating wars with the Swedish Empire , ending with large cessions of territory to Sweden. In the 19th century there was a surge of nationalist movements , which were defeated in the First Schleswig War.
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