Nutritional knowledge, dietary practices and nutritional adequacy of people living with hiv/aids in Nairobi, Kenya

Abstract

HIV infection reduces the intake, absorption, and utilization of nutrients especially micronutrients, The cycle between malnutrition and HIV/AIDS is vicious. In addition HIV infected persons have increased macronutrient requirements and are commonly deficient in almost all key micronutrients including vitamin A, B-complex, C, E, zinc, magnesium, iron and selenium. These can only be achieved if they have adequate and appropriate nutritional information, coupled with sound dietary practices. The objective of the study therefore was to determine nutritional knowledge, dietary practices and nutritional adequacy of proteins, calories, iron, vitamin A and C among people living with HIV and_AIDS. A cross-sectional study of both descriptive and analytic design involving purposively sampled 153 persons living with HIV/AIDS from Women Fighting Aids in Kenya and the staff members of the organization was conducted in July and august 2005. Data collection tools included a pre-tested semi-structured questionnaire that included a food frequency questionnaire, 24-hour recall questionnaire, key informant and focus group discussion guides. Data were collected on demographic and socioeconomic status, respondents' dietary practices and intake and nutritional knowledge including its sources. Two wellqualified and trained field enumerators assisted in data collection. The data were analyzed using SPSS software package. The P-value for statistical significance test was set at <0.05. Results showed that the average meal frequency was three times per day (inclusive of snacks), which was below the recommended 5-6 times per day. Calorie and vitamin A intake of 96.9% and 87.5% respondents was below the Recommended Daily Allowances. 96.9% and 68.8% of the respondents respectively had vitamin C and protein levels above the Recommended Daily Allowances. The study population had adequate intake of iron. Most respondents (71.9%) had an average dietary diversity scores. There was a strong association between dietary diversity and dietary adequacy. Nutritional knowledge among the respondents was inadequate because majority (61%) had average nutrition knowledge and none was ranked in the highest level. The quality of nutrition information sources was questionable. Only 13% of the respondents were on nutrition supplements at the time of study. Multiple micronutrient supplementations for PLWHA should be greater than one RDA per day from the time they are diagnosed. Access to the supplements was limited. Nutrient adequacy significantly increased with dietary diversity at P<O.05 and the two were positively and strongly associated with per capita income spent on food. Factors contributing to dietary adequacy included per capita income spent on food per day, dietary diversity, number of meals consumed in a day and size of the household all which had significant and positive association with the adequacy of nutrients. Thus nutrition being the core of good health for PLWHA, the government should set up strategies to ensure that well trained nutrition educationist are deployed at the community levels. Nutrient supplements should also be accessible so as to compliment the food consumed and thus ensuring adequacy. Further, the government and NGOs should support households affected and infected by HIV/AIDS to become economically stable and nutritionally secure.