Eating disorders among people living with HIV: findings from a systematic review

Existing research illustrates high rates of mental health disorders among people living with HIV (PLWH). This, combined with research indicating that body image disturbances are common among PLWH, suggests that PLWH may be at increased risk for eating disorders (EDs). Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and guided by syndemic theory, we conducted a systematic review to identify studies focused on EDs among PLWH. An initial search of 11 databases identified 17,855 articles. After removing duplicates, reviewers screened the titles and abstracts of 8454 articles. Of those articles, 143 articles moved to full-text review. The final synthesis included five studies - three case studies and two cross-sectional studies. We extracted data from and assessed the quality and risk of bias of these studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Included studies generally met minimum JBI appraisal thresholds for their respective designs, although there was incomplete reporting of adverse events in the case studies, and one of the cross-sectional studies did not adequately address confounders. Findings from this systematic review reveal a significant gap in the literature, suggesting that EDs among PLWH is a largely overlooked area of research. Integrated, theoretically informed research examining the prevalence of, risk factors for, and outcomes associated with EDs among PLWH is needed to better understand the burden of EDs in this population and to inform the development of targeted screening, prevention, and intervention strategies that improve both mental health and HIV-related health outcomes.