ABSTRACT
Food insecurity, defined as “the limited or uncertain availability of nutritionally adequate, safe foods or the inability to acquire personally acceptable foods in socially acceptable ways” [1], and its resultant adverse effects on nutritional status represent important negative influences on HIV outcomes in low-resource settings [2-5]. Studies have found that food insecurity is associated with poor adherence to anti-retroviral therapy (ART) in both resource-poor regions [4, 6-8], as well as among vulnerable populations in resource-rich settings [9-12]. Because of the link among food insecurity, poor nutritional status, and adverse HIV outcomes, the World Health Organization (WHO) recommends that
interventions to promote initiation of and adherence to ART include attention to a sufficient and balanced diet [13]. Research as to how to provide a healthy diet among PLHIV has identified several approaches: nutrition supplementation (e.g., specialized foods) with or without nutritional education/counseling; safety nets such as food, cash transfer or vouchers; and livelihood interventions such as small scale agriculture, livestock or sewing [14]. These interventionsespecially those providing food assistance-have been found to promote positive effects on nutrition status, quality of life, retention in care, adherence to treatment, and household food security among PLHIV [14, 15]. However, recent research has highlighted that nutrition education and counseling remain weak components of nutritional interventions for PLHIV [14].
