2 January 2020

Tackling HIV through Better Nutrition in Africa

Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are still global problems, with Africa remaining as the most affected continent. In this region of the world, according to UNAIDS data almost 500,000 deaths in 2018 were associated with HIV and AIDS related diseases despite the investment in Highly Active Antiretroviral Therapy and the collective efforts of health care workers. Without incorporation of quality diets, the therapy may not actually help to reduce HIV related morbidity and mortality rates.

People living with HIV/AIDS often experience progressive weight loss, as energy requirements of HIV positive individuals are higher than HIV negative individuals, so their food needs are likely to grow due to the complex relationship between HIV and nutrition. Body cells need energy and other nutrients for their functioning and when there is an infection, this demand increases as nutrients are essential for maintaining immunity. When the body of an individual is not able to meet this demand, it causes malnutrition.

This leads to a higher amount of HIV in the blood and poor quality of life. A study led by Dr. Temitope K. Bello from the Department of Human Nutrition at the Faculty of Health Sciences of the University of Pretoria (South Africa), a member institution of UNAI, addressed this issue by focusing on implementing an intervention on quality of life, environmental and behavioral factors that influence healthy food choices and access among adults living with HIV. For this, a needs assessment was conducted among 243 individuals in Nigeria.

The assessment revealed poor quality of life, food insecurity, poor nutrition knowledge and unhealthy eating behaviours. The needs identified were used to develop contextualized nutrition educational materials such as a trainer’s manual, brochure, participant’s workbook and flipcharts, using two specific learning approaches: social cognitive theory and the health belief model. A total of four materials were designed, and the intervention was evaluated before and after it took place. The research team from the institution also followed-up with the participants 12 weeks after the intervention itself.

The team found that the implementation of the aforementioned materials can be a driver of healthy decision-making, may impact food choices and even access. Beyond the financial barriers in accessing food, nutrition education intervention is likely to improve both quality of life and healthy-eating behaviours. Considering the relevance of nutrition as a key component in the management of HIV/AIDS, these findings provide useful information to improve programs that target low-income persons living with HIV.

Given the benefits of nutrition therapy in HIV infections, a nutritional assessment must be conducted by a specialist to have the patient’s baseline information so dietary counseling could start and then the planning for an effective nutritional support.  In this regard, and since the goal is to enhance the quality of life as well as its length in persons living with HIV, materials that could be designed and developed for communication or educational purposes must be an integral component of any strategy.

This article was written by Dr. Temitope K. Bello, professor in the Department of Human Nutrition at the Faculty of Health Sciences at the University of Pretoria (South Africa), the UNAI Hub for the Sustainable Development Goal 2: Zero Hunger.