Defining what Matters: Use of Q Methodology to Identify Food Values among People Living with HIV Affected by Food Insecurity

Objectives/Background. To inform the development of a "food is medicine" (FIM) intervention, the present study aimed to describe how people living with HIV (PLWH) prioritize daily food choices in the context of food insecurity. Methods. Interviews with PLWH experiencing various levels of food insecurity (n=24) were conducted using Q-Methodology. Participants ranked 57 food- choice value statements from "most like me" to "least like me" in a process called forced distribution. We then identified different viewpoints and shared perspectives through factor analysis. Results. Although food cost was a salient value, distinct viewpoints prioritized: 1) creative expression and sensory appeal; 2) disease management within physical limitations; 3) safety, familiarity, household practicality; 4) mainstream convenience; and 5) disease prevention and socioemotional coping. Discussion. Heterogeneous viewpoints on the relative importance of sensory appeal, functional capabilities, family food preferences, and other factors may affect whether and how future FIM participants use foods and related resources.