“I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy

Young, Sera L.; Natamba, Barnabas; Luwedde, Flavia; Nyafwono, Dorcas; Okia, Ben; Osterbauer, Beth; Natureeba, Paul; Johnson, Lynn M.; Michel, Chloé; Zheng, Amy; Robine, Marion; Achan, Jane; Charlebois, Edwin D.; Cohan, Deb; Havlir, Diane V.

doi:10.1007/s10461-014-0947-0

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…Accordingly, our qualitative interviews have revealed that PLHIV perceived the LNS as ‘beneficial in their recovery’ and ‘protective against the adverse effect of ART’ . The perceived beneficial effect of macronutrient supplements by PLHIV has also been reported in a Ugandan study . Another study found that PLHIV perceived ART as harmful when taken without adequate food .…”

Section: Discussionsupporting

confidence: 62%

The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial

Tesfaye

Kæstel

Olsen

et al. 2016

Tropical Med Int Health

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Abstractobjective To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART) and to investigate the effects of timing of supplementation by comparing with supplementation during the subsequent 3 months.methods A randomised controlled trial was conducted in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17 kg/m 2 and given daily supplements of 200 g of LNS containing whey or soya either during the first 3 months or the subsequent months of ART. The outcome was measured in terms of total quality-of-life scores on the adapted version of the WHOQOL-HIV-BREF assessed at baseline, three and six months.results Of the 282 participants, 186 (66.0%) were women. The mean age (SD) was 32.8 (AE9.0) years, and the mean (SD) total quality-of-life score was 82.0 (AE14.8) at baseline assessment. At 3 months, participants who received LNS showed better quality of life than those who only received ART without LNS (b = 6.2, 95% CI: 2.9: 9.6). At 6 months, there was no difference in total qualityof-life score between the early and delayed supplementation groups (b = 3.0, 95% CI: À0.4: 6.4). However, the early supplementation group showed higher scores on the social and spirituality domains than the delayed group.conclusions LNS given during the first three months of ART improves the quality of life of PLHIV.keywords lipid-based nutrient supplement, HIV, quality of life, low-income setting, food insecurity, antiretroviral treatment

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Section: Discussionsupporting

confidence: 62%

The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial

Tesfaye

Kæstel

Olsen

et al. 2016

Tropical Med Int Health

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“…In a food‐insecure setting such as south‐central Niger, improvements in the nutritional status of pregnant women can be facilitated with increased availability and access to foods that are affordable, beneficial, and acceptable to women at all stages of their pregnancy. Efforts to increase the availability of imported fortified nutritious foods with high consumer acceptability (Young et al, ), coupled with increased access to these items in village marketplaces through targeted interventions such as conditional cash transfers, could improve maternal nutrition among food‐insecure, rural Nigerien women. Efforts to integrate salient terms and discourses identified in this study into programming strategies, for example, culturally appropriate social and behaviour change communications promoting increased consumption of leafy green vegetables and other local nutrient‐rich produce during pregnancy, could help amplify gains in maternal nutrition achieved by the previously recommended market‐level interventions (Lamstein et al, ).…”

Section: Discussionmentioning

confidence: 99%

Determinants of dietary practices during pregnancy: A longitudinal qualitative study in Niger

Rosen

Clermont

Kodish

et al. 2018

Maternal & Child Nutrition

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Undernutrition is associated with maternal morbidity and poor pregnancy outcomes. This qualitative study seeks to understand the multilevel factors influencing maternal dietary practices in Niger, including the impact of pregnancy illnesses on diet. Criterion‐based, purposive sampling was used to select pregnant women and household members from 24 villages in a rural district of the Maradi Region in south‐central Niger. Semistructured interviews (n = 153) and focus group discussions (n = 38) explored 4 primary themes: (a) perceptions of ideal diet during pregnancy, (b) barriers to consuming the ideal diet, (c) coping strategies including dietary responses related to pregnancy illnesses, and (d) changes in perceptions from early to late pregnancy. Longitudinal data collection allowed for repeated interviews of pregnant women to document changes in dietary practices throughout pregnancy. Transcripts were coded using an inductive approach informed by grounded theory methodology. Participants categorized foods into 4 primary dietary taxonomies when discussing ideal maternal diets but cited constraints related to accessibility and availability impeding routine consumption of these foods. Perceptions of “modern,” urban foods as healthy, coupled with key structural barriers such as food costs, were identified. Maternal morbidity influenced food consumption, as women reported reducing food intake early in pregnancy in response to illness episodes. Although awareness of optimal foods for supporting healthy pregnancies was moderately high, some misconceptions were observed and multilevel barriers to food security restricted opportunities for consuming these foods. Nutrition‐specific and nutrition‐sensitive interventions could improve access and availability of acceptable foods for supporting increased dietary intake during pregnancy.

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“…Previous qualitative and mixed-methods studies have been conducted on the acceptability and utilization of IFA [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ], MMN [ 18 , 19 , 20 , 21 ], and LNS [ 16 , 22 , 23 ] in community settings in low-income countries. Measured levels of adherence to supplementation protocol have varied widely in these studies, from 95% in Mali [ 18 ] to 47% in Cambodia [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Acceptability and Utilization of Three Nutritional Supplements during Pregnancy: Findings from a Longitudinal, Mixed-Methods Study in Niger

et al. 2018

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Nutritional status in pregnancy is a key determinant of birth outcomes. In low-income countries, maternal diets are often limited, and daily nutrient supplements are recommended to fill nutrient gaps. As a result, it is important to understand the factors influencing acceptability and utilization of nutrient supplements in these settings. Qualitative data (individual interviews and focus group discussions with pregnant women, household members, and study staff) and quantitative data (unannounced household spot checks) were collected in 24 villages in the Maradi region of south-central Niger. Each village was randomly assigned to one of three study arms, with pregnant women receiving either iron and folic acid (IFA) supplements, multiple micronutrient (MMN) supplements, or medium-quantity lipid-based nutrient supplements (MQ-LNS) for daily consumption during pregnancy. Data were collected longitudinally to capture changes in perspective as women progressed through their pregnancy. Participants accepted all three supplement types, and perceived a wide range of health benefits attributed to supplement consumption. However, several important barriers to appropriate consumption were reported, and rumors about the supplements leading to childbirth complications also decreased utilization. The household spot checks suggested that IFA had the highest level of correct consumption. Overall, despite a stated high level of acceptance and enthusiasm for the supplements among participants and their household members, certain fears, side effects, and organoleptic factors led to decreased utilization. The effectiveness of future programs to improve maternal nutritional status through supplementation may be improved by understanding perceived barriers and facilitating factors among participants and tailoring communication efforts appropriately.

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“I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy

Cited by 8 publications

References 36 publications

The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial

The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial

Determinants of dietary practices during pregnancy: A longitudinal qualitative study in Niger

Acceptability and Utilization of Three Nutritional Supplements during Pregnancy: Findings from a Longitudinal, Mixed-Methods Study in Niger

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