Document Type




Previous studies showed that food insecurity could adversely affect clinical outcomes of people living with HIV (PLWH). The mental health pathways of such effects are suggested in existing literature, but empirical data are limited in resource-limited settings.


This cross-sectional study aims to explore the role of depressive symptoms and anxiety on the association between food insecurity and CD4 counts among a sample of 2,987 PLWH in Guangxi, China. Path analysis was used to examine a hypothetical model and delta ztest was used to assess the indirect effects of food insecurity on CD4 counts through depressive symptoms and anxiety.


The prevalence of food insecurity in this sample was 25.3%, and the median CD4 counts were 318 cells/mm3. In correlation analyses, food insecurity was not directly associated with LogCD4 but was associated with depressive symptoms and anxiety. Path analysis indicated a significant indirect effect from food insecurity to LogCD4 through depressive symptoms, but not anxiety.


Improving mental health among PLWH with food insecurity may be beneficial for treatment outcomes. Besides intervening food insecurity, an intervention targeting depressive symptoms could improve the immunologic outcomes of PLWH.

Digital Object Identifier (DOI)


© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

APA Citation

Chen, C., Yang, X., Zeng, C., Li, X., Qiao, S., & Zhou, Y. (2020). The role of mental health on the relationship between food insecurity and immunologic outcome among people living with HIV in Guangxi, China. Health Psychology And Behavioral Medicine, 8(1), 636-648.