Online Program

Building partnerships to address nutrition and food insecurity of people living with HIV (PLHIV) in latin america and the Caribbean

Tuesday, November 5, 2013 : 11:30 a.m. - 11:45 a.m.

Kathryn Pitkin Derose, PhD, MPH, Health Program, RAND Corporation, Santa Monica, CA
Kartika Palar, PhD, School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
Hugo Farias, BA, Regional Office for Latin America and the Caribbean, World Food Programme, Panama City, Panama
Harold Green Jr., PhD, Health Program, RAND Corporation, Santa Monica, CA
Jayne Adams, MSW, Regional Office for Latin America and the Caribbean, World Food Programme, Panama City, Panama
Blanca Ramirez, MPH, Honduras Country Office, World Food Programme, Tegucigalpa, Honduras
Alexandria Smith, MPH, Health Program, RAND Corporation, Santa Monica, CA
Homero Martinez, MD, PhD, Health Program, RAND Corporation, Santa Monica, CA
Poor nutrition and food insecurity negatively affect antiretroviral adherence and HIV outcomes, but few relevant interventions have been documented in Latin America and the Caribbean (LAC). RAND and the World Food Program formed a partnership to develop and evaluate pilot projects that address the nutritional needs and food insecurity among PLHIV in LAC. With local partners, we conducted formative research in Bolivia, Honduras, and the Dominican Republic among patients at HIV clinics (total n=390). Free listing and pile sorts identified frequently consumed, culturally salient foods; home and market visits supplied contextual information about food consumption, availability, and prices; anthropometric measurements assessed nutritional status; 24-hour food recalls measured micro and macro-nutrient intake; structured interviews collected socio-demographic, food frequency, and food security data; chart abstraction provided health status and adherence information. Common findings included: 1) most PLHIV had household food insecurity, frequently severe; 2) food insecurity often co-existed with overweight and obesity, particularly among women; 3) people's diets tended to be high in fats but low in protein and various micronutrients. Applying these findings in collaboration with local WFP country offices, governmental agencies, associations of PLHIV, and HIV clinics, we designed country-specific pilot projects incorporating locally-tailored nutrition counseling with one or more of the following: a monthly household food ration, linkage to income-generating projects, and/or urban gardens (evaluation is on-going). Formative research and inter-sectoral collaboration supported the design of locally appropriate nutritional interventions for PLHIV, enhanced local nutritional and research capacities, and helped incorporate nutritional guidelines into national policies and clinical practice.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Program planning
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the importance of nutrition and food security for comprehensive care of people with HIV. Describe qualitative and quantitative methods for assessing nutrition and food security of people with HIV in international settings. Identify the various ways that inter-sectoral collaboration can facilitate meeting the nutritional and food security needs of people with HIV.

Keyword(s): HIV Interventions, Food and Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have led RAND's efforts to partner with the World Food Program to conduct applied research on nutrition and food security of people with HIV in Latin America. I have participated in conceptualizing, implementing, and analyzing the results of these efforts. I have extensive field experience in Latin America, am bilingual, and have over twenty years experience in community health partnerships and conducting applied research to inform programs and policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.