Nutrition education and counselling as strategic interventions to improvehealth outcomes in adult outpatients with HIV: a literature review

Abstract

Malnutrition poses a significant risk for people living with HIV and accelerates disease progression. This is because adequate nutrition is essential for optimal immune function. This article discusses research on the role and use of nutrition education or counselling as a strategic intervention to improve health outcomes through better health behaviour in adult outpatients with HIV. Ten studies (five quantitative and five qualitative) met the inclusion criteria of the literature review. The findings of the studies related to the following outcomes of nutrition interventions: increases in fat-free and lean body mass; offsetting the adverse effects of HIV infection in patients with a low CD4 cell count; significant improvement in dietary patterns with resultant greater adherence to HIV medications and fewer side effects; and agreement on the importance of addressing the nutrition concerns. The article discusses the five prominent themes that emerged from the literature review: 1) ethical issues in HIV/AIDS research; 2) the role of health and culture in nutrition interventions; 3) HIV stigma and its impact on nutrition interventions; 4) the socioeconomics of HIV and AIDS; and 5) food security and emotional wellbeing among persons with HIV. Although the evidence base is limited and raises questions about key aspects of the quality of the research conducted to date, the overall results show that providing HIV-positive adults with culturally relevant and practical nutrition strategies can improve health outcomes, health behaviour and quality of life. Current and future nutrition interventions for persons with HIV disease should be targeted, sustainable, and rigorously evaluated. There is an urgent need for research on this topic in developing countries, particularly African ones, which are some of the most affected by HIV.

Keywords:

• clinical practice
• health education
• health needs
• health research
• malnutrition
• medical anthropology
• nutrient supplementation
• qualitative research
• quantitative research
• research methodology
• social determinants of health

Notes

1 Male and female participants at different stages of HIV infection were included in most of the studies reviewed. Apart from two studies (i.e. Tabi & Vogel, 2006; Van Niekerk et al., 2000), some if not all participants were receiving antiretroviral therapy. Upon enrolment all participants were free of secondary infection and were living as outpatients in either an urban or rural setting.