Care of Women with HIV Living in Limited-Resource Settings Overview of HIV and Nutrition

1. 1 Care of Women with HIV Living in Limited-Resource Settings Overview of HIV and Nutrition Ellen G. Piwoz, ScD Director, Center for Nutrition Nutrition Advisor, SARA Project Academy for Educational Development This tutorial draws heavily on the publication by Ellen Piwoz and Elizabeth Preble, HIV/AIDS and Nutrition: A Review of the Literature and Recommendations for Nutrition Care and Support in Africa. Students interested in more information about this topic should consult this publication. This tutorial draws heavily on the publication by Ellen Piwoz and Elizabeth Preble, HIV/AIDS and Nutrition: A Review of the Literature and Recommendations for Nutrition Care and Support in Africa. Students interested in more information about this topic should consult this publication.

2. 2 Objectives Review effect of HIV and AIDS on nutrition Discuss impact of nutrition interventions on HIV progression and mortality Describe nutritional considerations in mother-to-child transmission of HIV The following topics will be discussed in this tutorial: - What is the effect of HIV and AIDS on nutrition? - What is the impact of nutrition intervention on HIV disease progression and mortality? - What are the nutritional considerations with respect to the transmission of HIV from mothers to infants? Additional recommendations for nutrition care and support are addressed in the Nutrition Care and Support tutorial. The following topics will be discussed in this tutorial: - What is the effect of HIV and AIDS on nutrition? - What is the impact of nutrition intervention on HIV disease progression and mortality? - What are the nutritional considerations with respect to the transmission of HIV from mothers to infants? Additional recommendations for nutrition care and support are addressed in the Nutrition Care and Support tutorial.

3. 3 Types of Malnutrition Protein-energy malnutrition (PEM) Measured in terms of body size Micronutrient malnutrition Often referred to as “hidden hunger” Not easy to see unless it is severe Iron, vitamin A and iodine are the most commonly reported micronutrient deficiencies in both children and adults Deficiencies of other nutrients common in settings with infectious diseases, food insecurity Let’s begin with a discussion of the forms of malnutrition that are common in resource-poor settings. Malnutrition takes many forms. These include protein-energy malnutrition (PEM) and micronutrient malnutrition. Protein Energy Malnutrition is usually measured in terms of body size, such as weight, height, body fat and muscle mass. Micronutrient malnutrition is more difficult to measure. It is often called ‘hidden hunger’ because it is difficult to recognize until it becomes severe. Iron, vitamin A and iodine are the most commonly reported micronutrient deficiencies in children and adults. Deficiencies of other micronutrients that are vital for the body’s normal functions, including the work of the immune system, also frequently affect women living in resource-poor settings, particularly if they suffer from infectious diseases and food insecurity. Let’s begin with a discussion of the forms of malnutrition that are common in resource-poor settings. Malnutrition takes many forms. These include protein-energy malnutrition (PEM) and micronutrient malnutrition. Protein Energy Malnutrition is usually measured in terms of body size, such as weight, height, body fat and muscle mass. Micronutrient malnutrition is more difficult to measure. It is often called ‘hidden hunger’ because it is difficult to recognize until it becomes severe. Iron, vitamin A and iodine are the most commonly reported micronutrient deficiencies in children and adults. Deficiencies of other micronutrients that are vital for the body’s normal functions, including the work of the immune system, also frequently affect women living in resource-poor settings, particularly if they suffer from infectious diseases and food insecurity.

4. 4 Consequences of Malnutrition in Women Increases women’s morbidity and mortality Zinc, vitamin A deficiencies increase the risk of sexually transmitted diseases Iron deficiency reduces resistance to disease, causes fatigue, and reduces women’s productivity Low calcium intake increases risks of pre-eclampsia, high blood pressure and hypertension during pregnancy Anemia increases risks of prolonged labor, and death due to hemorrhage Affects infant birth outcome and health Intrauterine growth and birth weight Nutrient stores for later development Growth and survival