People living with Human Immunodeficiency Virus may lack access to sufficient quantities of nutritious foods and are vulnerable to food insecurity. Studies suggest there is gender-based inequality in the experience of food insecurity. The few studies conducted on the prevalence of food insecurity among adults living with Human Immunodeficiency Virus in Ethiopia presented inconclusive findings. Therefore, the objective of the current systematic review and meta-analysis was to estimate the pooled

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... prevalence of food insecurity and its gender disparity among adult patients living with HIV and receiving antiretroviral therapy in Ethiopia.Method We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The research databases PubMed, Google Scholar, CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library and the WEB OF SCIENCE were searched using keywords. We included studies reporting prevalence of food insecurity among adults aged greater than 18 years who were living with HIV and receiving antiretroviral therapy. The meta-analysis was conducted using STATA 14 software. A random effects model was used to estimate the pooled prevalence at 95% CI. Funnel plots and Egger's and Begg's tests were used to check for publication bias.Results A total of 52 studies representing 4031 adults were identified; eleven studies were included in the meta-analysis. The overall pooled estimated prevalence of food insecurity was 63.44% (95% CI: 46.33-80.54%). A higher pooled prevalence of food insecurity was observed among females (68.85%, 95% CI (57.88%, 79.81%)) compared to males (31.15%, 95% CI (20.19%, 42.12%)).Conclusion The review demonstrates a high prevalence of food insecurity among people living with HIV in Ethiopia, with evidence of greater vulnerability among women. Interventions should be culture and context specific to address regional and gender disparities in the prevalence of food insecurity.