Household Food Insecurity but not participation in a Nutrition Assessment and Counselling Support (NACS) program is significantly associated with current BMI in People Living with HIV/AIDS (PLWHA) in the Greater Accra Region of Ghana

Abstract

BackgroundGhana has about 230,000 adults living with HIV. Nutrition plays a key role in the management of HIV. The NACS program developed by USAID's (U.S. Agency for International Development) FANTA (Food and Nutrition Technical Assistance) project seeks to enhance access to nutrition services for PLWHA in developing countries, including Ghana.Objectives To determine whether Ghanaian PLWHA participating in NACS differ from non‐participants by age, sex, BMI, and food insecurity. To determine factors associated with BMI among this group of PLWHA. MethodsSeventy‐seven adult PLWHA participating in NACS at three district hospitals in Accra and 75 not participating in NACS, in three comparable district hospitals in the same region were recruited into this study in 2015. Participants’ height and weight were measured using a stadiometer and digital scale, respectively. Food insecurity was assessed using the Household Food Insecurity Access Scale. Analysis of covariance was used to evaluate baseline characteristics by participation in NACS, and the association between food insecurity and BMI.ResultsAmong 152 participants (mean age=39.9yrs; 84% female), 26.5% were overweight (BMI=25–29 kg/m2) and 20.5% obese (BMI ≥30 kg/m2). Over a third (36.2%) were classified severely food insecure by the guidelines of the HFIAS. Participants in NACS did not differ from those who were not in NACS in age, sex, food insecurity and BMI. Amongst all participants, food secure PLWHA had a BMI 4.2 kg/m2 higher compared to severely food insecure (p=0.0002) after multivariable adjustments.ConclusionFood insecurity is associated with a lower BMI in this group of PLWHA. Interventions to improve BMI among PLWHA in this region should consider including components which will improve food security.Future stepsParticipants will be followed for the next 6 months with measurements repeated at 3 and 6 months to prospectively assess the impact of the NACS program on their BMI.Support or Funding InformationBrown/Tufts/Miriam Fogarty AIDS International Training and Research Program (2D43TW000237)