Food Security Status, Dietary Practices and Nutritional Status of People Living with HIV and AIDS in Homabay Town, Kenya
Nyamunsi, Naom Mokono
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The HIV and AIDS prevalence in Kenya is 7.2%. HIV and AIDS affect the livelihoods of the PLWHA and consequently their food security status. The country’s food security relies heavily on its agricultural production. Food insecurity that influences dietary practices affects about 12% of Kenyans in urban households and the presence of HIV and AIDS worsens the situation. There is limited data available on the magnitude of food insecurity among PLWHA in Kenya and the effect on dietary practices and nutrition status. The main objective of this study was to assess the food security, dietary practices and the nutritional status of PLWHA aged 18-55 years in Homa Bay town in Kenya. The study used a cross-sectional analytical study design that allowed for the collection of both quantitative and qualitative information at one point in time. The study adopted a sample of 333 PLWHAs that was drawn from a population of about 723 PLWHAs in Homa Bay town and its immediate outskirts. Homa Bay town was divided into five and from the list obtained from the clinic; proportion to size method was used to allocate the sample to each village. Systematic random sampling method was used to select the sample in each village at an interval of 3. A structured questionnaire was used to collect data on demographic and socio-economic characteristics, food security status, dietary practices and anthropometry. A focus group discussion guide was used to collect more information. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 15.0. Analysis comprised of descriptive statistics such as mean, percentages and frequencies. Chi square test was used to assess relationships between categorical variables while Pearson correlation analysis to establish the strength of association between non-categorical variables. Nutri-survey was used to analyze dietary intake data from the 24-hour recall. Body Mass Index (BMI) calculator was used to convert anthropometric measurements to BMI. T-test for independent samples was used to determine if there were significant differences between the study variables for males and females. Significance levels were determined at 95% confidence interval where a p-value of <0.05 was considered significant. Qualitative data was summarized, coded and analyzed to establish emerging themes. This study found out that 27.4% of the study population were food insecure as indicated by household dietary diversity score (HDDS) of <5. The mean HDDS was 4.72±0.11, which is an indicator of low nutrient intake. The intake of energy, fat and selected micronutrients namely iron, zinc, vitamin A, B6 and C was inadequate for >20% of respondents. About 19.6% were undernourished (BMI <18.5). Results show that, 6.8% of the respondents self-reported to have been affected by malaria, 0.6% by tuberculosis and 2.5% by pneumonia in the two weeks preceding the study.There were significant relationships between HDDS and energy (p=0.042), HDDS and micronutrients intake (p<0.05), energy intake and BMI (p=0.029) as well as the relationship between HDDS and BMI (p=0.015). Results also showed significant relationships (p<0.05) between the intake of vitamin A, vitamin C, iron and zinc and absence of illness. The study noted moderate food insecurity (27.4%) which correlated with poor dietary practices and poor nutritional status. The study recommends scaling up of food and nutrition security interventions in the region by the government and other stakeholders.