Waihenya, Rahab Nyakweya2026-03-172026-03-172025-10https://ir-library.ku.ac.ke/handle/123456789/32778A 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, October 2025. Supervisors 1. Prof. Judith Waudo (Ph.D) 2. Prof. Sophie Ochola (Ph.D)Human immuno-deficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) remains a public health issue in many countries, around the world. To manage the pandemic, efforts have been made to strengthen Community Health Strategy by using community health promoters (CHPs). Despite long term use of CHPs, there is research gap on their nutrition knowledge, attitudes and practices and the extent to which these affect the overall management of HIV. The study thus sought to assess the nutrition knowledge, attitudes and practices of CHPs providing care and support to People Living with HIV (PLHIV) in Kawangare, Nairobi County. Cross-sectional analytical study design was used (mixed quantitative and qualitative data). Simple random sampling used to select 129 CHPs and purposive sampling for Key Informants (KII). Semi-structured researcher-administered questionnaires, Focus Group Discussions (FGDs) and KII Interviews were used to collect data. Collected data was then entered and analyzed using Statistical Package for Social Sciences (SPSS) version 22. An overall knowledge score categorized as low (< 40%), moderate (41-69%) and high (>70%) was used to establish CHPs’ nutrition knowledge. Likert scale was used to measure and determine attitude of the CHPs. CHPs’ practices were assessed using nutrition care standards derived from Kenya’s Ministry of Health’s National guidelines on HIV. Chi-square test, direct logistic regression and Fisher's exact tests were used to determine relationships between variables at 0.05 level of significance. Qualitative data was analysed using content analysis based on pre-determined thematic areas. Results showed that a majority of respondents (70%) were females. The mean age was 42 ± 15 years and majority had completed secondary education, were unemployed relied on less than KShs. 10,000 per month. Majority of CHPs had high nutrition knowledge. Most CHPs had positive attitudes towards nutrition in HIV management. Mean attitude score was 6.1±1.3. During home visits major activities by CHPs were; education/counseling and follow ups/ referrals with the least activity being food support and distribution. The common messages passed to clients during home visits were; drinking plenty of clean safe water, practice positive living behavior and sanitation and hygiene with the least being nutrition requirements and healthy diet. The study established a positive relationship between CHPs' knowledge and attitudes (p=0.021). However, there was no relationship between CHP's knowledge scores and practices (p> 0.05) as shown by Fischer’s test and there was also no relationship between, CHP's attitudes and their practices (p=0.78) as shown by direct logistic regression test. The nutrition service delivery was mainly affected by inadequate remuneration, inadequate working tools, lack of transport and PLHIV household food insecurity. The study recommends that the Ministry of Health and relevant stakeholders support CHPs with other means of income generating interventions, develop CHPs’community based nutrition and HIV curriculum, capacity build CHPs on nutrition and new HIV management techniques through trainings and reinforce the role of CHPs as part of the HIV care team. There is need for further research on CHPs’ working relationship with other HIV health workers and on perception of PLHIV on quality of nutrition services offered by the CHPs.enThesis