Undernutrition and its predictors among people living with HIV/AIDS attending antiretroviral therapy clinic in Jimma University Specialized Hospital

Abstract

HIV is one of the most serious health and development challenge of the globally with approximately 36.9 million people currently living with HIV and tens of millions of people having already died since the emergence of the pandemic. Food insecurity and poor nutritional status could enhance the progression to AIDS-related illnesses and compromise adherence and response to antiretroviral therapy. However, factors associated with nutritional status of HIV positive people is not well documented in Ethiopia in general and in the study area in particular. The aim of this study was to determine the prevalence of undernutrition and associated factors among adult people living with HIV/AIDS. An institution-based cross-sectional study was conducted on among a total of 305 people living with HIV/AIDS attending Antiretroviral therapy in Jimma University Specialized Hospital from January to March 2014/2015. A systematic sampling technique was used to select study participants. Semi-structured and pre-tested questionnaire was used to collect socio-demographic data, while beam balance and stadiometer were used to measure weight and height of the study participants, respectively. Body mass index was calculated by dividing weight of subjects in k.g by their height in meters squared. Bivariate and multivariable logistic regression analyses were used to identify independent predictors of undernutrition as measured by body mass index < 18.5 kg/m2. P value <0.05 was considered for statistical significance. The prevalence of undernutrition was 27.2% (95% CI 22.2–32.2). Multivariable logistic regression analysis revealed that alcohol consumption (AOR=0.13[95%CI: 0.05-0.32]), WHO clinical stage I (AOR=0.2[95%CI:0.07-0.52]), WHO clinical stage II(AOR=0.25[95%CI:0.085-0.75]) and DDS(AOR=3.67[95%CI:1.72-7.817]) were significantly associated with undernutrition. Compared to cases with an advanced WHO stage of the disease (stage V), case with the stages I to II were less likely to have undernutrition (P<0.05). Similarly, compared to those with lower dietary diversity, subjects with high dietary diversity were less likely to have undernutrition (AOR=3.67[95%CI: 1.72-7.817, P=0.001]). Likewise, those not consuming alcohol were less likely to be undernourished compared to the ones who consume alcohol (AOR=0.13[95%CI: 0.05-0.32, P=0.001]). The prevalence of undernutrition among HIV/AIDS patients in Jimma University Specialized Hospital was high. Alcohol consumption, WHO clinical stage and DDS were significant independent predictors of undernutrition among People living with HIV/AIDS. Concerted efforts should be made to create awareness through behavior change communication for all patients about no or optimal alcohol consumption and dietary diversification. Key words: Undernutrition, HIV/AIDS, Adult.