Nutritional and Food Security Status of HIV+ Adults on Antiretroviral and Therapeutic Nutrition at Kibra Informal Settlement, Nairobi City County, Kenya
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Date
2025-07
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Kenyatta University
Abstract
Antiretroviral therapy (ART) is the use of antiretroviral (ARV) medication to inhibit viral replication and delay immune deterioration. ART plays a critical role in the management of HIV by suppressing viral replication and improving immune function. An appropriate diet is vital when ART commences. The nutritional needs of HIV+ adults are immense and have a great impact on HIV/AIDS management outcomes. The effectiveness of ART is closely linked to the nutritional status and dietary diversity of HIV+ adults. Despite the well-documented importance of nutrition in HIV management, limited research has fo-cused on the dietary diversity and nutritional outcomes of HIV-positive adults on ART in Kenya’s informal settlements. This study assessed the socio-demographic and economic characteristics of HIV-positive adults on ART, evaluated their dietary diversity and nutri-tional status, examined the relationship between dietary diversity and nutritional status and the relationship between socio-economic characteristics and both dietary diversity and nutritional status. A cross-sectional analytical study was conducted among HIV-positive adults attending health centres in Kibra informal settlement, Nairobi City Coun-ty, Kenya. Data were collected using structured questionnaires, 24-hour dietary recalls, food frequency questionnaires, and anthropometric measurements including Body Mass Index (BMI) and Mid-Upper Arm Circumference (MUAC). Descriptive statistics, chi-square tests, Fisher’s exact test, and bivariate regression analysis were conducted using Statistical Package for Social Sciences (SPSS) version 20. The Individual Dietary Diversi-ty Score (IDDS) and Minimum Dietary Diversity for Women (MDD-W) were used to assess dietary diversity, while nutritional status was categorized by BMI. Multivariable logistic regression identified significant predictors of dietary diversity and nutritional sta-tus. Findings revealed that 55.7% of respondents had low dietary diversity, with only 7% attaining high dietary diversity. Meal frequency and wealth index were significant predic-tors of dietary diversity (p<0.001 and p=0.019, respectively). Most respondents (57.4%) had normal nutritional status, while 8.7% were undernourished and 35.7% were over-weight or obese. Statistically significant associations were found between dietary diversi-ty variables such as being on a special diet (p=0.033), receiving nutrition counselling (p=0.023), meal frequency (<0.001) and food shortage (0.048), and nutritional status (p<0.05). Some socio-economic and socio-demographic factors showed a significant as-sociation with dietary diversity and nutritional status. The study concludes that dietary diversity remains low among HIV+ adults in informal settlements, with direct implications for their nutritional health and ART outcomes. The findings underscore the need for en-hanced nutrition-focused interventions integrated into HIV care, routine monitoring of dietary diversity and nutritional status. Further research on how improvements in dietary diversity influence nutritional status and ART adherence over time, the impact of nutri-tion counselling and food support on nutritional outcomes among HIV-positive adults as well as gender-based disparities in dietary access and nutritional vulnerability among HIV-positive adults to inform interventions strategies is recommended
Description
A Research Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science (Food, Nutrition and Dietetics) in the School of Health Sciences of Kenyatta University, July, 2025
Supervisor;
1.Judith Kimiywe
2.Elizabeth Kuria