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.