Three decades after HIV first emerged, the virus is no longer a death sentence. Thanks to antiretroviral therapy drugs, a newly-diagnosed 20-year-old can now expect to live for 50 more years.

But a new study by researchers in British Columbia underscores the fact that treating HIV has to do with more than just giving patients drugs — ensuring they are well fed matters too.

The study looked at the connection between food security and HIV survival rates, tracking 254 injection drug users across British Columbia over 13 years.

Roughly 71 per cent of those patients reported being food insecure when they first began their HIV treatments — and the study found that those patients were twice as likely to die.

“The introduction of life-saving antiretroviral therapy has significantly reduced HIV-related morbidity and mortality,” said senior author Robert Hogg in a press release. “However, the impact of insufficient access to food, particularly quality food, on the mortality of HIV-positive injection drug users is alarming.”

HIV/AIDS and food insecurity are “intertwined in a vicious cycle that heightens vulnerability to, and worsens the severity, of each condition,” according to this 2009 study.

There are many ways in which food insecurity can increase one’s risk of contracting HIV in the first place, the 2009 study notes. Surveys in Swaziland and Botswana have found that food insecure women are 80 per cent more likely to enter the sex trade and 70 per cent more likely to have unprotected sex. Food insecurity also leads to malnutrition, which can make people more susceptible to HIV infections by compromising their immune systems and “gut and genital mucosal integrity.” Otherstudies have also suggested that malnourished mothers are more likely to transmit HIV to their babies.

Food insecurity has also been linked with poorer drug effectiveness and lower adherence rates to treatment regimens. One paper cited in the 2009 study noted that HIV patients in Uganda receiving free drugs were still forced to choose between spending their money on transportation to clinics and using their limited funds towards feeding their children.

The 2009 study concluded that there is a growing recognition of how food insecurity impacts HIV survival rates but much more research is still needed to better understand the link.

Hogg notes that his study is only the first to examine the impact of food insecurity on HIV survival rates amongst injection drug users.

“The research points to the urgent need to further investigate the impact of food insecurity on the health outcomes of people living with HIV/AIDS,” he said in the press release.

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar