PCP HIV AIDS Toolkit/Biology of HIV AIDS/Handout E: Nutrition and HIV AIDS

Handout E: FACT SHEET - Nutrition and HIV/AIDS
Proper nutrition is an important part of the overall care of people living with HIV/AIDS (PLWA) since it plays a vital role in improving and prolonging the quality of life of those infected and affected. A healthy diet can help to strengthen the immune system which boosts resistance to disease and infection, increases energy, allows an individual to remain productive and effectively able to contribute to family and community for as long as possible.

What is the link between nutrition and HIV/AIDS?
There is a strong relationship between HIV and nutrition. Malnutrition leads to a weakened immune system, which allows HIV to more quickly progress to AIDS. Both HIV and malnutrition can independently cause progressive damage to the immune system and increased susceptibility to infection, morbidity, and mortality through opportunistic infections, fever, diarrhea, loss of appetite, nutrient malabsorption and weight loss. HIV specifically affects nutritional status by increasing energy requirements, reducing food intake, and adversely affecting nutrient absorption and metabolism.

What is good nutrition for PLWA?
Overall, good or adequate nutrition for PLWA is considered the consumption of a balanced healthy diet, consisting of locally available foods (animal foods, beans, fruits, nuts, starchy staples and vegetables), and clean water. However, depending upon the age and phase of the virus, individuals infected with HIV can require an additional energy intake of 10 percent (asymptomatic adults) to 100 percent (symptomatic children with weight loss); therefore, their nutrient requirements would be greater than those of healthy individuals.

Energy Requirement Increases for PLWA
=== What are the components of a nutritional care and support program for PLWA? ===

It is important for Volunteers to work with their counterpart(s) when implementing a nutritional care and support program. Additionally, efforts should be made to minimize any aspect that might stigmatize an individual and/or family.


 * Nutrition assessment
 * Gather information about the current nutritional status and diet.
 * Identify potential risk factors, as well as positive eating habits. Make sure to include: food prices, food seasonality, perceived importance of the food item, local preferences, food assistance program participation, access to clean water sources, and other relevant data. If possible, ascertain the nutritional value of foods most easily accessible and/or grown, and explore ways with community members to diversify the diet.
 * When applicable, refer the individual for a physical assessment: measurements of weight, mid-arm circumference, height, and a calculation of body mass index.
 * Nutrition education and counseling - Include information about:
 * Adequate nutrient intake
 * Food safety and hygiene
 * Physical activity
 * Healthy lifestyle
 * Symptom management - Provide people living with HIV/AIDS strategies to manage nutrition-related HIV symptoms and/or side effects: nausea, vomiting, diarrhea, anorexia, difficulty chewing/swallowing, mouth sores, and/or changes in taste.
 * Nutrition management of antiretroviral therapy - Address any drug interactions with foods, beverages, and herbs.
 * Discuss the management of nutrition related to drug/medication side effects.
 * Psychosocial support - Listen and allow the person living with HIV/AIDS to voice any concerns and/or emotions about his/her disease and nutritional status.
 * Targeted nutritional supplements - Know what type of (if any) nutritional supplementation is provided‚Äîfood rations to micronutrient supplementation.
 * Other support mechanisms - Inquire about additional resources available in the community that seek to enhance nutrition and food security of individuals and families affected by HIV/AIDS.

What can Volunteers do to help improve the nutritional status of PLWA?

 * Nutrition education
 * Promotion of indigenous plants that boost immune system
 * Incorporation of the permaculture philosophy into farming
 * Support for community gardens
 * Enhanced small-scale livestock production
 * Hygiene and sanitation education
 * Promote access to clean water sources

Resources

 * Food and Nutritional Technical Assistance Project, 2004. HIV/AIDS: A Guide for Nutritional Care and Support. www.fantaproject.org.
 * Living Well with HIV/AIDS: A Manual for Nutritional Care and Support for People Living with HIV/AIDS, Rome, Italy: FAO/WHO, 2002. Available at: www.fao.org.
 * Report on Food and Nutrition for People Living with HIV/AIDS, Washington, DC: The President's Emergency Plan for AIDS Relief, May 2006. Website: http://www.state.gov/documents/organization/66769.pdf
 * Nutrient Requirements for People Living with HIV/AIDS Report of a Technical Consultation, World Health Organization, Geneva, 13-15 May 2003. Website: http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf
 * Policy Guidance on the Use of Emergency Plan Funds to Address Food and Nutrition Needs: President's Emergency Plan for AIDS Relief, September, 2006. Website: http://www.pepfar.gov/guidance/