Integrating nutrition security with treatment of people living with HIV: Lessons from Kenya
Integrating nutrition security with treatment of people living with HIV: Lessons from Kenya
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DOI：
10.1177/156482650802900202
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发表时间：
2008-06-01
影响因子：
1.9
通讯作者：
Nangami, Mabel
中科院分区：
文献类型：
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作者：
Byron, Elizabeth;Gillespie, Stuart;Nangami, Mabel
背景艾滋病毒阳性者对热量的需求增加，治疗的不良副作用可能因营养不良而恶化（但通过营养支持得到缓解），以及相关的依从性下降和耐药性可能增加，这些都是制定更好的干预措施以加强接受抗逆转录病毒治疗者的营养安全的理由。强调与旨在加强正在接受抗逆转录病毒治疗的艾滋病毒感染者的营养安全的干预措施有关的主要惠益和挑战。方法. 2005年底和2006年初，对肯尼亚西部艾滋病毒感染者提供免费抗逆转录病毒治疗的短期营养干预措施进行了定性研究。在治疗方案中加入食物计划的患者自我报告更好地坚持他们的药物，副作用更少，满足食欲增加的能力更强。大多数客户自我报告体重增加，体力恢复，并恢复劳动活动，而参加双重（食物补充和治疗）计划。这种改善被认为是催化增加家庭和社区的支持。这些研究结果为呼吁对艾滋病流行病与长期营养无保障并存的问题采取更全面和综合的对策提供了进一步的实证支持。今后需要开展工作，澄清如何弥合向个人提供短期营养支助与为受艾滋病影响的社区制定长期生计保障方案之间的差距。在这种环境下，农业和卫生部门必须采取部门间行动，配合这种跨学科研究。
Background. The increased caloric requirements of HIV positive individuals, undesirable side effects of treatment that may be worsened by malnutrition (but alleviated by nutritional support), and associated declines in adherence and possible increased drug resistance are all justifications for developing better interventions to strengthen the nutrition security of individuals receiving antiretroviral treatment.Objective. To highlight key benefits and challenges relating to interventions aimed at strengthening the nutrition security of people living with HIV who are receiving antiretroviral treatment. Methods. Qualitative research was undertaken on a short-term nutrition intervention linked to the provision of free antiretroviral treatment for people living with HIV in western Kenya in late 2005 and early 2006.Results. Patients enrolled in the food program while on treatment regimens self-reported greater adherence to their medication, fewer side effects, and a greater ability to satisfy increased appetite. Most clients self-reported weight gain, recovery of physical strength, and the resumption of labor activities while enrolled in dual (food supplementation and treatment) programs. Such improvements were seen to catalyze increased support from family and community.Conclusions. These findings provide further empirical support to calls for a more holistic and comprehensive response to the coexistence of AIDS epidemics with chronic nutrition insecurity. Future work is needed to clarify ways of bridging the gap between short-term nutritional support to individuals and longer-term livelihood security programming for communities affected by AIDS. Such interdisciplinary research will need to be matched by intersectoral action on the part of the agriculture and health sectors in such environments.