Abstract
BackgroundFew data are available to guide programmatic solutions to the overlapping problems of undernutrition and HIV infection. We evaluated the impact of food assistance on patient outcomes in a comprehensive HIV program in central Haiti in a prospective observational cohort study.MethodsAdults with HIV infection were eligible for monthly food rations if they had any one of: tuberculosis, body mass index (BMI) <18.5kg/m2, CD4 cell count <350/mm3 (in the prior 3 months) or severe socio-economic conditions. A total of 600 individuals (300 eligible and 300 ineligible for food assistance) were interviewed before rations were distributed, at 6 months and at 12 months. Data collected included demographics, BMI and food insecurity score (range 0 - 20).ResultsAt 6- and 12-month time-points, 488 and 340 subjects were eligible for analysis. Multivariable analysis demonstrated that at 6 months, food security significantly improved in those who received food assistance versus who did not (-3.55 vs -0.16; P < 0.0001); BMI decreased significantly less in the food assistance group than in the non-food group (-0.20 vs -0.66; P = 0.020). At 12 months, food assistance was associated with improved food security (-3.49 vs -1.89, P = 0.011) and BMI (0.22 vs -0.67, P = 0.036). Food assistance was associated with improved adherence to monthly clinic visits at both 6 (P < 0.001) and 12 months (P = 0.033).ConclusionsFood assistance was associated with improved food security, increased BMI, and improved adherence to clinic visits at 6 and 12 months among people living with HIV in Haiti and should be part of routine care where HIV and food insecurity overlap.
Highlights
Food insecurity and undernutrition are increasingly recognized as factors that are important in the health and livelihoods of individuals living with human immunodeficiency virus (HIV) infection in poor settings [1,2]
The aim of this study was to determine the impact of targeted food assistance on the body mass index (BMI), quality of life and household food security of people living with HIV in a comprehensive health program in central Haiti
This study finds that providing food assistance to individuals with HIV and food insecurity in central Haiti improves BMI, food security and adherence to clinic visits
Summary
Food insecurity and undernutrition are increasingly recognized as factors that are important in the health and livelihoods of individuals living with HIV infection in poor settings [1,2]. The qualitative effect of food on relieving hunger is not in doubt, the quantitative benefits of food assistance on individuals or on families has rarely been studied in the context of HIV [16]. The aim of this study was to determine the impact of targeted food assistance on the body mass index (BMI), quality of life and household food security of people living with HIV in a comprehensive health program in central Haiti. We evaluated the impact of food assistance on patient outcomes in a comprehensive HIV program in central Haiti in a prospective observational cohort study
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