NUTRITIONAL STATUS ASSESSMENT OF HIV-POSITIVE WOMEN ATTENDING CLINICS AT SENTINEL SITES IN AKWA IBOM STATE, NIGERIA

Abstract

HIV-Positive Women (HPW) are nutritionally vulnerable and account for 60% of PLWHA in Nigeria. Adequate dietary intake has been found to improve the nutritional status of People Living With HIV/AIDS (PLWHA). Anti Retroviral Therapy (ART) is the mainstay in the management of PLWHA, but the influence of nutritional status of HPW has not been fully investigated in Nigeria. This study was designed to assess nutritional status and its association with ART use among HPW in HIV clinics at sentinel sites of Akwa Ibom State, Nigeria. A descriptive cross sectional study involving 231 HPW selected from all four national HIV sentinel sites in Uyo (UY), Iquita-Oron (IO), Ikono (IK) and Urua-Akpan (UA) was carried out. Akwa Ibom State was purposively selected being the second highest in HIV surveillance in Nigeria and all HIV and treatment clinics at the sentinel sites were used. Systematic random sampling technique was used to select every third HPW that met criteria and had clinic appointment on each day of data collection. An interviewer-administered semi-structured questionnaire was used to collect information on socio-demographics, ART use, 24 hour dietary recall and anthropometric measurements. Dietary Intake was analysed using adapted Total Diet Assessment software, height and weight were measured with standard methods. Body Mass Index (BMI) was calculated and categorised using WHO standards. Dietary Diversity Score (DDS) derived from the 24 hour dietary intake was measured on a scale of 0-9 and a Women Dietary Diversity (WDD) tercile of ≤3, 4-5 and 6-9 were categorised as low, average and high respectively. Data was analysed using descriptive statistics, ANOVA, Chi-square tests and logistic regression at 5% level of significance. Age of respondents was 29.7±6.8 years, 37.7% were single, 53.7% attained secondary education, 75.8% were employed and 84.4% of respondents were currently on ART. Of those currently on ART, 44.1% had been on ART for more than 52 weeks. Mean daily energy intake (2008.3±856.1 kcal) of respondents on ART was significantly higher than that of respondents not on ART (1686.0±736.5kcal). The proportion of respondents with inadequate, adequate and excess energy intakes were 45.0%, 35.9%, 19.0% respectively. The DDS of respondents using ART (4.3±0.8) was significantly higher (4.0±1.1) than those not using ART, about 80.0% respondents had average WDD tercile and respondents consumed mostly starchy staples. The BMI of respondents in UY, IO, IK and UA were 23.3±2.1kg/m2, 21.7±3.5 kg/m2, 24.4±4.4 kg/m2 and 20.7±3.4 kg/m2 respectively. Underweight occurrence among respondents using ART (8.2%) was significantly lower than those (25.0%) not using ART. The use of ART was significantly associated with normal BMI of respondents and respondents not on ART were less likely to have normal BMI (OR=0.3, CI=0.097-0.691). HIV-positive women who used anti retroviral therapy had better nutritional status than those who did not. Adherence to anti retroviral therapy should be encouraged to maintain good nutritional status among HIV-positive women.