Tailored Nutrition Education and Food Assistance Improve Adherence to HIV Antiretroviral Therapy: Evidence from Honduras

Martı́nez, Homero; Palar, Kartika; Linnemayr, Sebastian; Smith, Alexandria; Derose, Kathryn Pitkin; Ramírez, Blanca; Farias, Hugo; Wagner, Glenn

doi:10.1007/s10461-014-0786-z

Cited by 54 publications

(65 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While a growing literature has documented the mostly positive impacts of food assistance on medication adherence and other outcomes for people with HIV in lowincome countries [44,45], the USA and other highincome countries lack parallel studies. Among people with diabetes, a recent prospective study in the USA suggests that medically appropriate "food boxes" tailored for a diabetic diet, provided together with diabetes selfmanagement and linkage to care, may improve glycemic control and other markers of diabetes health, including fruit and vegetable intake, self-management, and medication adherence [29].…”

Section: Discussionmentioning

confidence: 99%

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

et al. 2017

Self Cite

View full text Add to dashboard Cite

Food insecurity is associated with negative chronic health outcomes, yet few studies have examined how providing medically appropriate food assistance to food-insecure individuals may improve health outcomes in resource-rich settings. We evaluated a communitybased food support intervention in the San Francisco Bay Area for people living with HIV and/or type 2 diabetes mellitus (T2DM) to determine the feasibility, acceptability, and potential impact of the intervention on nutritional, mental health, disease management, healthcare utilization, and physical health outcomes. The 6-month intervention provided meals and snacks designed to comprise 100% of daily energy requirements and meet nutritional guidelines for a healthy diet. We assessed paired outcomes at baseline and 6 months using validated measures. Paired t tests and McNemar exact tests were used with continuous and dichotomous outcomes, respectively, to compare pre-post changes. Fifty-two participants (out of 72 initiators) had both baseline and follow-up assessments, including 23 with HIV, 24 with T2DM, and 7 with both HIV and T2DM. Median food pick-up adherence was 93%. Comparing baseline to follow-up, very low food security decreased from 59.6% to 11.5% (p < 0.0001). Frequency of consumption of fats (p = 0.003) decreased, while frequency increased for fruits and vegetables (p = 0.011). Among people with diabetes, frequency of sugar consumption decreased (p = 0.006). We also observed decreased depressive symptoms (p = 0.028) and binge drinking (p = 0.008). At follow-up, fewer participants sacrificed food for healthcare (p = 0.007) or prescriptions (p = 0.046), or sacrificed healthcare for food (p = 0.029). Among people with HIV, 95% adherence to antiretroviral therapy increased from 47 to 70% (p = 0.046). Among people with T2DM, diabetes distress (p < 0.001), and perceived diabetes self-management (p = 0.007) improved. Comprehensive, medically appropriate food support is feasible and may improve multiple health outcomes for food-insecure individuals living with chronic health conditions. Future studies should formally test the impact of medically appropriate food support interventions for food-insecure populations through rigorous, randomized controlled designs.

show abstract

Section: Discussionmentioning

confidence: 99%

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Aberman et al [29] assess the global action in response to the AIDS epidemic in the context of food and nutrition security interventions as well as the evolution of policy supporting their integration into HIV programming. Martinez et al conclude with a study from Honduras where the provision of household assistance in the form of a food basket and nutrition education improved adherence to HIV treatment by 20 % (p = 0.01) within 6 months among 400 clients with previous sub-optimal adherence [30]. Key messages on food and nutrition assistance to increase uptake and retention in care and treatment…”

Section: Adherence Food Security and Nutritionmentioning

confidence: 97%

“…eligibility for therapeutic or supplementary food, integration of nutrition assessment counseling and support, linkages to HIV sensitive and HIV specific safety nets, referral systems to PMTCT and reproductive health, social protection, etc.) and communities (behavioral interventions at community level using task shifting and health care workers to track malnourished clients, creating nutrition support centers and referral systems) [27] • Socio-economic consequences of TB include stigma, social isolation, increased out-of-pocket expenditures for medical and non-medical costs and reduced income [28] • Social transfers in the form of food, cash or vouchers can mitigate the negative effects of TB by enabling diagnosis seeking behaviours, protecting minimum food expenditures, reducing the need to accumulate debt and reduce productive assets [28] • Social transfers also reduce the negative impacts on other household members, particularly young children and school-age children [28] • A current practice is the integration of nutrition assessment, counseling, and support (NACS) in the HIV response by strengthening links between nutrition and specific services by the health, agriculture, food security, social protection, education, and rural development sectors for more comprehensive care [29] • Nutrition supplementation and safety nets in the form of food assistance and livelihood interventions have potential in certain contexts to improve food security and nutrition outcomes in an HIV/AIDS context [29] • Providing household assistance in the form of a food basket along with nutrition education improved adherence to HIV treatment by 20 % (p = 0.01) among a group of non-adherent patients [30] Demand side barriers related to socioeconomic status, social norms and knowledge, and physiology may be objective or also only subjective (i.e. fear of unbearable side effects, when these may actually be tolerable) [25] S462 AIDS Behav (2014) 18:S459-S464…”

Section: Adherence Food Security and Nutritionmentioning

confidence: 99%

See 1 more Smart Citation

Adherence to HIV and TB Care and Treatment, the Role of Food Security and Nutrition

2014

View full text Add to dashboard Cite

Food security and nutrition play an important role in HIV and TB care and treatment, including for improving treatment outcomes, adherence and uptake of HIV and TB care. This AIDS and behaviour supplement on ''Adherence to HIV and TB care and treatment, the role of food security and nutrition'' provides an overview of the current evidence and knowledge about the barriers to uptake and retention in HIV and TB treatment and care and on whether and how food and nutrition assistance can help overcome these barriers. It contains nine papers on three topic areas discussing: (a) adherence and food and nutrition security in context of HIV and TB, their definitions, measurement tools and the current situation; (b) food and nutrition insecurity as barriers to uptake and retention; and (c) food and nutrition assistance to increase uptake and retention in care and treatment. Future interventions in the areas of food security, nutrition and social protection for increasing access and adherence should be from an HIV sensitive lens, linking the continuum of care with health systems, food systems and the community, complementing existing platforms through partnerships and integrated services.

show abstract

“…People living with HIV (PLHIV) can improve their appetite with antiretroviral drug therapy (ART) to maintain their CD4 cells and viral load at an optimal level to prevent complications from opportunistic infections (i.e., tuberculosis, pneumonia, etc.) and to keep their physiological functioning normal, especially, sensory sensations to improve taste and smell to increase their appetite and amount of food intake [2]. In Thailand, the number of PLHIV having access to ART has increased compared to the past decade due to the government universal health care program.…”

Section: Introductionmentioning

confidence: 99%

Quality of food consumption and development of eating disorders among people living with HIV

Singhato¹,

Booranasuksakul²,

Rueangsri³

et al. 2017

HIV & AIDS Review

View full text Add to dashboard Cite

Human immunodeficiency virus (HIV) infection largely impacts on the nutritional status of infected patients. At present, advance in medicine and pharmaceuticals such as antiretroviral drugs help improve health status among people living with HIV (PLHIV). Improving appetite for PLHIV by regaining their normal taste sensation and enhanced naso-oral stimulation can help promote their consumption of larger amounts of food. Previous studies have shown how bad HIV infection affects mental status, which leads to the development of many health problems including eating disorder. This is a cross-sectional study aimed to investigate characteristics of food consumed by PLHIV and comparing that between high-risk and low-risk eating disorder groups. The developed self-respondent questionnaires (baseline questionnaire, eating disorder screening questionnaire, self-adherence questionnaire, and 3-day food record) were completed by 132 HIV infected patients at the Queen Savang Vadhana Memorial Hospital, Chonburi province. The results in a high-risk group were not significant on energy distribution (carbohydrate, protein, fat) compared with a low-risk group, but the data indicated that the high-risk group had a significantly higher intake of saturated fat and sodium compared with the low-risk group. In addition, results indicated that the high-risk group was significantly lower in self-adherent score and CD4 level compared with the low-risk group.

show abstract

Tailored Nutrition Education and Food Assistance Improve Adherence to HIV Antiretroviral Therapy: Evidence from Honduras

Cited by 54 publications

References 28 publications

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

Adherence to HIV and TB Care and Treatment, the Role of Food Security and Nutrition

Quality of food consumption and development of eating disorders among people living with HIV

Contact Info

Product

Resources

About