HIV/AIDS, Undernutrition, and Food Insecurity

Abstract

Despite tremendous advances in HIV care and increased funding for treatment, morbidity and mortality from HIV/AIDS in developing countries remains unacceptably high. A major contributing factor is that globally over 800 million people remain chronically undernourished and the HIV epidemic largely overlaps with populations already suffering from low diet quality and quantity. We present an updated review of the relationship between HIV, nutritional deficiencies and food insecurity, and consider efforts to interrupt this cycle at a programmatic level. As HIV infection progresses, it causes a catabolic state and increased susceptibility to infection which are compounded by lack of caloric and other nutrient intake, leading to progressive worsening of malnutrition. Despite calls from national and international organizations to integrate HIV and nutrition programs, data are lacking on how such programs can be effectively implemented in resource-poor settings, on the optimum content and duration of nutrition support and on ideal target recipients.

Health and Treatment Implications of Food Insufficiency among People Living with HIV/AIDS, Atlanta, Georgia

“…Food can impede HIV wasting, and eating is necessary for the proper absorption of some ARV medications. 3,6 In addition, the independent association between food insufficiency and HIV treatment adherence observed in this study demonstrates that providing people with access to food and reducing their alcohol intake may have positive effects on treatment adherence, which in turn will result in improved health benefits. The concept of increasing access to food to improve HIV-related health and treatment adherence was tested in a study conducted with HIV-positive persons in Zambia.…”

“…2 Hunger and food insufficiency are prevalent in people living with HIV/AIDS, even in the most well-resourced cities. 3 For example, nearly half of HIV-positive individuals receiving drug treatment in British Columbia, Canada were identified as food insecure, a rate that was five times greater than the general Canadian population. 4 Food insecurity was significantly greater among women and aboriginals and was associated with having more children, less education, a history of recreational injection drug and/or alcohol abuse, and unstable housing.…”

Food insecurity of HIV/AIDS patients at a unit of outpatient healthcare system in Brasilia, Federal District, Brazil

“…Among individuals with this disease, food insecurity is associated with decreased adherence to treatment, low cluster of differentiation (CD4) cell counts, increased viral load, incomplete suppression of HIV, an increase in opportunistic infections, and decreased survival rates of individuals [5][6] . Despite the guidelines from international organizations to integrate HIV and nutrition programs, the effective implementation of such programs depends on database development and information management 7 . This requires knowing the situation of food insecurity in relation to this disease and the mechanisms that lead to it.…”

Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

“…Food insecurity (FI) exists when these conditions are not met and is a major underlying cause of undernutrition enshrined in the UNICEF conceptual framework (1,2) . FI is a major risk factor for adverse health outcomes among specific vulnerable populations including persons infected with HIV (3,4) , women (5) and children (5,6) . Women's responsibilities in managing family feeding (7) , gender bias in the experience of FI (8) and unequal control over household resources make them particularly vulnerable to FI and its consequences (3) .…”