While all people require proper nutrition to maintain good health, it is especially essential to people living with HIV/AIDS (PLWHA). The side effects of some HIV/AIDS medications result in drastic weight loss due to their causing excessive vomiting and/or diarrhea. Such side effects as well as particular HIV symptoms can be successively managed through a nutritionally appropriate diet. Adequate nutrition helps to keep the immune system strong thus enhancing the body’s ability to fight opportunistic infections. Additionally, many medications require a full stomach before taking them. Maintaining good nutrition through eating a variety of healthy foods allows the body to maximize the effectiveness of several prescribed drug treatments.

Malnutrition among PLWHA
People living with HIV/AIDS may be at a higher risk for malnutrition because of any or all of the following reasons: reduced food intake, malabsorption of nutrients, changes in metabolism, and food insecurity.

Reduced food intake
As is common with illness of any kind, PLWHA frequently experience a loss of appetite. Appetite loss may result from anxiety, depression, fatigue, fever, infection, or side effects of medications. Related infections that cause sores in the gastro-intestinal tract or mouth can make eating difficult or painful, further contributing to a person’s decreasing desire to eat. When an individual eats less food, his or her body receives fewer of the nutrients it needs in order to function at its fullest capacity.

Malabsorption
HIV/AIDS can affect the body’s ability to properly absorb nutrients. Diarrhea is a common symptom of HIV that results in the loss of essential nutrients, even if they are consumed in adequate quantities. HIV and diarrhea also damage the villi – tiny, finger-like protrusions that line the walls of the small intestine – thereby reducing the surface area available for absorption of nutrients.

Changes in metabolism
A change in metabolism alters the way the body uses, stores, and excretes nutrients. HIV/AIDS increases the body’s metabolism which results in it requiring more energy. Opportunistic infections and fevers can increase the requirement for energy even further.

Food Insecurity
Food insecurity refers to the lack of access to enough nutritional food to sustain a healthy, active lifestyle. Individuals may understand the importance of good nutrition in fighting HIV, but they may face social, physical, and/or economic barriers that prevent them from accessing or maintaining a healthy diet.

Antiretrovirals and Nutrition
Some foods can affect the absorption, metabolism, distribution, and excretion of certain antiretroviral drugs (ARVs). ARVs can have many side effects that undermine a person’s nutritional status and cause them to consume less food. Side effects can include nausea, vomiting, loss of appetite, diarrhea, and changes in taste. However, a healthy diet can reduce these side effects and make medications more tolerable and treatment regimens easier to adhere. , In order to maximize the efficacy and minimize or avoid any potential adverse reactions of ARVs, HIV-positive people should talk to a nutritionist to learn what foods should be integrated into their diets to best maximize the efficacy of their treatment plan. Visit Association of Nutrition Services Agencies to find a provider near you.

The Impact of Food Insecurity on PLWHA
In 2004, 11.9% of U.S. households experienced food insecurity, which is often the result of an event that places stress on a household’s budget. For HIV-positive individuals, this financial stress may be due to expensive healthcare costs, especially since 69% of the estimated total people living with HIV/AIDS in the U.S. are either uninsured or are covered through federal programs like Medicaid or Medicare. Low-income HIV-positive people are too often forced to choose between paying for their lifesaving medications and the nutritious diet that will allow the medications to work.

Food programs – such as home-delivered meal programs, food stamps, and food pantries – are essential in breaking the cycle of HIV infection and malnutrition. In fact, of all the support services delivered by organizations receiving CARE Act funds, the food bank and home-delivered meals services had the highest reported use in 2002, with 113,673 participating individuals. However, these services are still underutilized. The USDA estimates that only about 60% of eligible individuals participated in the federal Food Stamp Program in FY 2004, meaning that millions more are missing out on this first line of defense against hunger and malnutrition. To learn more about the Food Stamp Program visit http://www.fns.usda.gov/fsp/.