Psychosocial correlates of nutritional status among people living with HIV on antiretroviral therapy: A matched case-control study in Central zone of Tigray, Northern Ethiopia

Abstract

BackgroundMalnutrition hastens progression to Acquired Human Immunodeficiency Syndromes (AIDS) related illnesses; undermines adherence and response to antiretroviral therapy (ART) in resource-poor settings. However, nutritional status of people living with HIV (PLHIV) can be affected by various psychosocial factors which have not been well explored in Ethiopia. Therefore, the objective of this study was to determine psychosocial correlates of nutritional status among people living with HIV (PLHIV) on ART in Central zone of Tigray, Northern Ethiopia.MethodsA matched case-control study design was conducted to assess psychosocial correlates of nutritional status among PLHIV on ART. Data were collected by an interviewer-administered technique using structured pre-tested questionnaire, record review using a checklist and anthropometric measurements. Cases were selected by simple random sampling and controls purposively to match the selected cases. Conditional logistic regression was used to compute relevant associations by STATA version 12.ResultsThe psychosocial factors independently associated with malnutrition were ever consuming alcohol after starting ART [AOR = 4.7, 95% CI: 1.8–12.3], ever smoking cigarette after starting ART [AOR = 7.6, 95% CI: 2.3–25.5], depression [AOR = 2.8, 95% CI: 1.3, 6.1], not adhering to ART [AOR = 6.8,95% CI: 2.0–23.0] and being in the second lowest wealth quintile [AOR = 4.3,95% CI: 1.1–17.7].ConclusionEver consuming alcohol and ever smoking cigarette after starting ART, depression, not adhering to ART and being in the second lowest wealth quintile were significantly associated with malnutrition. Therefore; policies, strategies, and programs targeting people living with HIV should consider psychosocial factors that can impact nutritional status of people living with HIV enrolled on ART.

Reducing Undernutrition through Counseling on Diversified Food Intake among Adult People Living with HIV on HAART, Northern Ethiopia

“…Other finding was people living with HIV on ART having below average monthly income (mean � 1200 ETB) had higher odds of cases. is is in line with a study done in Kenya [31], Tigray Region, Ethiopia [32], Democratic Republic of Congo [33], Uganda [34], Dilla University Referral Hospital, Ethiopia [7], and Zimbabwe [29] which indicates that poor socioeconomic factors leads to lack of access to food and is associated with undernutrition among people living with HIV enrolled on antiretroviral treatment.…”

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

“…The strong association that we found between ART adherence and undernutrition is also fairly well established [3,12,15,24] and in keeping with other recent studies in sub-Saharan Africa [43] that find a relationships between food insecurity, undernutrition, and difficulties in patient adherence and treatment initiation [14]. Several studies have found that concerns about having an adequate amount of food might people to stop or delay treatment [7,15,17].…”

“…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.…”

Magnitude of non-adherence to antiretroviral therapy and associated factors among adult people living with HIV/AIDS in Benishangul-Gumuz Regional State, Ethiopia

“…In similar with the findings of other studies in Ethiopia (Berhe, Tegabu & Alemayehu, 2013), the current study found malnourished PLWHA were non-adherent to ART. This is also reported in another matched case-control study in the Central Tigray Zone, Ethiopia that revealed malnutrition was among the independent factors associated with lack of adherence to ART (Weldehaweria et al, 2017). Absence of nutritional support fuels the synergistic co-existence of HIV and malnutrition that has a perverse effect on ART adherence and the wellbeing of PLWHA (Mekuria et al, 2015;Sicotte et al, 2014;Berhe, Tegabu & Alemayehu, 2013).…”