As SNAP benefits run low, people with HIV can struggle to stay on treatment

Despite major advances in HIV treatment, food and housing insecurity can still make it difficult for people living with the virus to take their medication consistently, according to an article by WHYY News.

Dr. Aaron Richterman, an infectious diseases specialist at Penn Medicine in Philadelphia, told WHYY that he would often hear patients say, “How am I supposed to take my medicine when I don’t have enough to eat?”

Some of Richterman’s patients at Penn rely on the Supplemental Nutrition Assistance Program, or SNAP, to buy food. He set out to examine whether the timing of their monthly benefits was associated with how consistently they took their HIV medication.

Richterman and his colleagues used electronic pill bottle caps to monitor medication adherence. Their study, published in JAMA Network Open, analyzed data from 54 adults living with HIV in Philadelphia who experienced food insecurity. Participants took their medication more consistently in the weeks after receiving SNAP benefits, but adherence declined toward the end of the monthly benefits cycle. The researchers noted that the study’s small sample and focus on one city limited how broadly its findings could apply.

Related: How SNAP cuts will disproportionately impact some LGBTQ+ people

Today, most people living with HIV who take their medication as prescribed can achieve an undetectable viral load within six months of starting treatment. Treatment helps people live long, healthy lives, and those who achieve and maintain an undetectable viral load cannot transmit HIV through sex. This globally accepted scientific consensus is known as U=U, or “undetectable equals untransmittable.”

But the stress of not having enough food or stable housing can make it harder to maintain a medication routine. Treatment interruptions can allow the virus to multiply, threatening a person’s health and potentially increasing the risk of sexual transmission if viral suppression is lost.

Richterman said the results underscore that access to medication alone does not eliminate the barriers patients face. Helping them obtain food, housing and other essential support, he explained, “can be much more important than whatever kind of medical counseling I give them.”

While Richterman’s research focuses on HIV, he’s also studying how the SNAP benefit cycle might affect patients with other chronic conditions, such as diabetes and high blood pressure. Other physicians see similar connections between unmet basic needs and difficulty staying on treatment.

“It highlights that so many things outside of health care and medicine significantly impact our patients’ health, probably beyond what my medications actually do,” Dr. Sam Albanesi, an infectious disease physician at the Jonathan Lax Treatment Center at Philadelphia FIGHT, a health services and advocacy organization, told WHYY. “I keep people living longer and healthier lives, but without access to things like food, water, shelter … my patients really, really struggle.” Albanesi was not involved in the study.

Changes to federal benefits programs could create additional obstacles. In 2025, new federal rules expanded SNAP work requirements in Pennsylvania, requiring some recipients to document qualifying work, volunteer service, education or training unless they qualify for an exemption.

Changes to SNAP have already contributed to thousands of Philadelphians losing benefits, according to experts interviewed by Billy Penn. Documentation requirements can create barriers even for people who remain eligible, the outlet reported.

Albanesi said he also expects upcoming Medicaid changes to create more barriers to HIV care. Under rules taking effect in January 2027, some Pennsylvania recipients will have to renew their eligibility every six months instead of annually and document that they meet new work requirements or qualify for an exemption. He told WHYY that about half of his patients receive Medicaid and that he expects the additional hurdles to cause some to fall out of care.