Household Food Security and Nutritional Status of Hiv Sero-Positive Clients Attending Longisa County Hospital Comprehensive Care Clinic, Bomet County, Kenya
Tonui, Kenneth Kipngeno
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Food insecurity remains a major problem in poor households, and its implications worsen in disease states including Human Immunodeficiency Virus (HIV) and AIDS. More than 10 million Kenyans are chronically food insecure and 1.6 million have HIV. A synergistic relationship exists between food insecurity, HIV, and AIDS. Human Immunodeficiency Virus and AIDS cause an imbalance of the four fundamental elements of food security: food access, availability, utilization, and stability. There is limited literature on household food (in) security and nutritional status of HIV sero-positive clients drawn from areas that have in recent times reported poor food production. Bomet County recently experienced poor production of county’s staple: maize, due to the emergence of Maize Necrosis disease, which resulted in increased harvest losses. The main purpose of the study was to assess the household food security and nutritional status of HIV sero-positive clients attending Comprehensive Care Clinic at Longisa County Hospital, Bomet County. The study used a cross-sectional analytical design on a comprehensive sample of 210 adult HIV sero-positive clients. A structured questionnaire was used to collect data on socio-demographic and socio-economic factors, anthropometric measurements, dietary intake, and food security status. Analysis was done using descriptive statistics, which included means, percentages, standard error of the mean, and frequencies. Pearson-moment correlation was used to establish strength of associations between continuous variables and Chi-square for relationship between categorical variables. Independent-Samples t-test was used to ascertain the existence of significant differences in the study variables across the male and female gender categories. One-Way ANOVA was used to determine the existence of significant difference in the means of categorical variables and non-categorical variables. A p-value of < 0.05 was used as the criterion for statistical significance. Data drawn from 24-hour dietary recall was analysed using Nutri-survey. SECA calculator model 491 was used for accurate determination of the Body Mass Index (BMI). Majority of the respondents: (61.6%) were females. Adequacy in meeting energy requirements was 47.4% for males and 50% for females. Males and females met the dietary needs for selected nutrients: vitamin A, B1, B2, C. Iron intake was significantly low among female respondents whereby 89.3% did not meet the RDI and zinc intake among male respondents was low as only 28.9% met the RDI. Consumption frequency of meats, eggs, and fish was irregular. Household food insecurity prevalence was 17.7% as evidenced by a Household Dietary Diversity Score (HDDS) of ≤4. About 23.7% of the respondent’s households had severe household hunger. Mean Household Hunger Scale score was 1.56±0.061 indicating that most of the respondent’s households experienced moderate household hunger. The prevalence of underweight was 22.8%. There was a significant relationship between nutritional status measured by BMI and household food security status measured by HDDS at p=0.001. Household food security status measured by HHS and nutritional status as assessed by MUAC had a positive association at p=0.001. Dietary intake and nutrition status did not exhibit any relationship. The study recommends the need to scale up care and treatment modalities at Comprehensive Care Clinics (CCC’s) by considering and including household food security and nutritional status aspects as part of nutritional care and support modalities for HIV sero-positive clients. This provides an ample means of optimizing ART, enhancing rehabilitation, and adherence to care and treatment.