Food Insecurity, Dietary Diversity, and Body Mass Index of HIV-Infected Individuals on Antiretroviral Therapy in Rural Haiti

Rebick, Gabriel; Franke, Molly F.; Teng, Jessica E.; Jerome, J. Gregory; Ivers, Louise C.

doi:10.1007/s10461-015-1183-y

Cited by 13 publications

(14 citation statements)

References 23 publications

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“…We found no association between undernutrition, educational level, urban residence, home ownership and access to public municipal goods such as electricity and piped water. Wealth or income of patients on ART has been found to be negatively associated with undernutrition in Haiti [54], and Brazil [55], as was educational status in Senegal [19] and wealth in Tigray, Ethiopia [43]. The lack of association may reflect the largely urban make up of our sample or simply the weakness of these measures in capturing socio-economic status.…”

Section: Discussionmentioning

confidence: 83%

“…It was found to have weak positive association with malnutrition in Brazil, no effect on low BMI in Haiti, and a negative association with malnutrition in Senegal. In older HIV-infected adults, more advanced age is associated with lower BMI [56] although the evidence is mixed [19,54]. The uncertainty around the impact of age on nutritional status suggests that further study on this topic is needed.…”

Section: Discussionmentioning

confidence: 99%

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Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design

et al. 2019

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Background: A complex and negatively reinforcing relationship exists between infection with Human Immune Deficiency Virus (HIV) and malnutrition. HIV-induced immune impairment and its resulting opportunistic infections (OIs) can lead to malnutrition and nutritional deficits, can, in turn, hasten the progression of HIV infection and reduce chances of survival. The determinants of undernutrition among patients receiving antiretroviral therapy (ART) is poorly understood in Ethiopia, despite a high prevalence of food-insecurity that overlaps with a generalized HIV/AIDS epidemic. Therefore, this study aimed to assess determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos Referral Hospital in Northwest Ethiopia. Methods: We conducted an institution-based, unmatched, case-control study with 636 adult patients receiving antiretroviral therapy. We randomly selected 212 patients with poor nutritional outcomes (cases) and 424 without undernutrition (controls) and then conducted a chart review to collect information on their treatment, socio-economic, and demographic background. Data were analyzed using bivariable and multivariable logistic regression to identify factors associated with under nutrition. Results: We found that greater age (AOR = 1.02, 95% CI: 1.01,1.05), fair or poor adherence (AOR = 2.77, 95% CI: 1.40, 5.50 and AOR = 4.72, 95% CI: 1.92, 11.6), and the presence of OIs (AOR = 1.70, 95% CI: 1.12, 2.52), anemia (AOR = 1.81, 95% CI: 1.07, 3.07), or eating problems (AOR = 3.40, 95% CI: 2.27, 5.10), were all independently and positively associated with under nutrition. Starting treatment with a medium or low CD4 count was protective (AOR = 0.61, 95% CI: 0.39, 0.96 and AOR = 0.49, 95% CI: 0.27, 0.88). Having social support (AOR = 0.64, 95% CI: 0.43, 0.95), and having a source of informal care-giving (AOR = 0.48, 95% CI: 0.27, 0.84), reduced the odds of undernutrition. Conclusion: Our findings support calls for treating HIV infection early and aggressively, while closely monitoring patients for opportunistic infections that might affect eating and drug side effects that may affect appetite. The role of disclosure, peer-caregivers and age in preventing undernutrition should be explored in future research.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design

et al. 2019

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“…The maintenance of a balanced and healthy diet, as well as physical activity, are considered to be care measures that contribute to health promotion and are fundamental to keep up physical and emotional health. Such health practices provide improved QL for the individuals, lowering mortality rates and increasing adherence to antiretroviral treatments, which are directly linked to improving the immune system ( 20 ) .…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of educational material for the health promotion of individuals with HIV

Jesus

Caliari

Oliveira

et al. 2020

Rev. Latino-Am. Enfermagem

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Objective: to develop and validate an educational technology for individuals living with the human immunodeficiency virus. Method: a methodological study, for the elaboration of educational material. The educational needs, content selection, and illustrations were defined from interviews with the target population. Afterward, we carried the writing, the material layout elaboration, and assembly and, subsequently, it was validated by specialists. The content validation was established from the Level Content Validity Index higher than 0.8. Results: the educational material was prepared for adults living with the human immunodeficiency virus, with a focus on health promotion and quality of life, and was prepared in five volumes. The validation was made by 22 multi-professional judges selected according to the criteria established in the study. All items were evaluated as relevant by the judges and the average obtained with the index was 0.97. Conclusion: the booklet has been validated in terms of content, language, and appearance by experts in the field. We believe that through this technology it is possible to contribute to the health literacy and empowerment of individuals living with the human immunodeficiency virus, strengthening their autonomy.

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“…A study among HIV-positive and HIV-negative women in Rwanda found that although levels of food insufficiency and low dietary diversity were substantial (46% and 43%, respectively), no significant correlations were found between either of these factors and BMI (Sirotin et al, 2012). Finally, a study in Haiti found that at baseline 89% of PLHIV in a food supplementation trial had either moderate or severe food insecurity, but food insecurity was negatively related to BMI (i.e., as food insecurity level increased, BMI decreased) (Rebick, Franke, Teng, Gregory Jerome, & Ivers, 2016). Given the high prevalence of both household food insecurity and obesity among PLHIV in resource poor settings, our study aims to inform policy, programming, and practice to improve ART adherence and HIV treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Severe food insecurity is associated with overweight and increased body fat among people living with HIV in the Dominican Republic

Derose

Ríos-Castillo²,

Fulcar³

et al. 2017

AIDS Care

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Food insecurity is an important risk factor for overweight and obesity among low-income populations in high income countries, but has not been well-studied among people living with HIV (PLHIV), particularly in resource-poor settings. To explore the association between food insecurity and overweight and obesity among PLHIV in the Dominican Republic, we conducted a cross-sectional study of 160 HIV-infected adults between March-December 2012 in four geographically-dispersed health centers (Santo Domingo, Puerto Plata, San Juan, and Higuey). We collected information on household food insecurity, anthropometric measurements, and socio-demographic data and ran descriptive and multivariate analyses, controlling for fixed effects of clinics and using robust standard errors. Mean age ± SD of participants was 39.9 ± 10.5 years; 68% were women, and 78% were on antiretroviral therapy (ART). A total of 58% reported severe household food insecurity. After controlling for age, gender, income, having children at home, education, and ART status, severe food insecurity was associated with increased body mass index (BMI) (β = 1.891, p = 0.023) and body fat (β = 4.004, p = 0.007). Age and female gender were also associated with increased body fat (β = 0.259, p < 0.001 and β = 8.568, p < 0.001, respectively) and age and ART status were associated with increased waist circumference (β = 0.279, p = 0.011 and β = 5.768, p = 0.046, respectively). When overweight was examined as a dichotomous variable (BMI ≥ 25.0), severe food insecurity was associated with an increased odds of 3.060 (p = 0.013); no other covariates were independently associated with overweight. The association of severe food insecurity with increased BMI, body fat, and overweight among PLHIV has important implications for clinical care as well as food security and nutrition interventions in resource-poor settings. Integrated programs that combine nutrition education or counseling with sustainable approaches to addressing food insecurity among PLHIV are needed to improve long-term health outcomes of this vulnerable population.

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Food Insecurity, Dietary Diversity, and Body Mass Index of HIV-Infected Individuals on Antiretroviral Therapy in Rural Haiti

Cited by 13 publications

References 23 publications

Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design

Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design

Construction and validation of educational material for the health promotion of individuals with HIV

Severe food insecurity is associated with overweight and increased body fat among people living with HIV in the Dominican Republic

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