Perceptions and determinants of healthy eating for people with HIV in theDominicanRepublicwho experience food insecurity.
Perceptions and determinants of healthy eating for people with HIV in theDominicanRepublicwho experience food insecurity.
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Date
2020-08-24
Authors
Amarilis Then Paulino
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Abstract
Food insecurity is defined as limited or uncertain access to sufficient nutritious food. Food insecurity is associated with various infectious and non-communicable health outcomes and is a major public health issue for people living with HIV (PLHIV. Food insecurity is associated with poor HIV outcomes through psychosocial, behavioural and nutritional pathways. Moreover, nutrition has a direct impact on viral load beyond behavioural pathways (i.e. antiretroviral therapy (ART) adherence and missed clinic appointments. Food insecurity is associated with decreased efficacy of ART and reduced ART adherence, which can lead to the immunologic decline and progression to AIDS, and increased morbidity and mortality for PLHIV. A study among PLHIV experiencing food insecurity in Honduras found that nutritional counselling improved ART adherence, HIV outcomes and reduced food insecurity for participants regardless of nutrition status. Relatedly, self-management behaviours such as consuming a quality diet, with quality defined as how well an individual conforms to dietary recommendations, are positively associated with improved health outcomes for PLHIV. A multinational qualitative study found that among PLHIV in resource-poor settings, chronic stress and structural barriers such as poor food diversity, unemployment and poverty impeded engagement with dietary behaviors. An intervention that targeted food insecurity by providing community-based food assistance found decreased consumption of fats, increased consumption of fresh fruits and vegetables and increased adherence to ART.
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Then-Paulino, A. (2020). Perceptions and determinants of healthy eating for people with HIV in the Dominican Republic who experience food insecurity. Public Health Nutrition, 24(10), 3018–3027.