Does nutritional intervention impact people with HIV?

The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda

Speaker: Dr Suneetha Kadiyala, London School of Hygiene & Tropical Medicine
Date: 26 September, 2013
Venue: Lower Meeting Room, LIDC, 36 Gordon Square, London

Although the last decade has seen increased access to anti-retroviral therapy (ART) across the developing world, widespread food insecurity and under-nutrition continue to compromise an effective response to the AIDS epidemic. Limited evidence exists on the potential benefit of food security and nutrition interventions to people living with HIV (PLHIV).

The researchers capitalised on an existing intervention to HIV infected individuals in Uganda, to design and conduct a prospective quasi-experimental study evaluating the impact of a monthly household food basket, provided to food insecure ART naïve PLHIVs for 12-months. The outcomes of interest were nutritional status [body mass index (BMI); mid-upper arm circumference (MUAC), and haemoglobin (Hb) concentrations], disease severity (CD4 count), and two measures of food security: diet quality [Individual Dietary Diversity Score (IDDS)] and food access (Household Food Insecurity Access Scale (HFIAS)). A difference-in-difference propensity score matching was used to examine the impact of food assistance.

The study found that food assistance significantly increased BMI by 0.6 kg/m2 (P< 0.01), and MUAC by 6.7 mm (P<0.05). They found no impact of food assistance on CD4 count, Hb concentrations, or IDDS. When restricting the analysis to individuals with CD4 counts >350 cells/μL, however, large significant impacts on Hb concentrations (1 g/dL; P<0.05) was evident. At the household level, food assistance improved food security as measured by the HFIAS, by 2.1 points (P<0.01).

This study, supported by 3ie, adds to the scant evidence base and demonstrates the potential for food assistance programming to be part of the standard of care for PLHIV in areas of widespread food insecurity.

This seminar is co-hosted by 3ie-LIDC and the Centre for Evaluation, LSHTM  

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