National Nutrition and HIV/AIDS Guidelines for Service Providers of ...

from medical providers as large doses can be harmful. As such clients should be cautioned
against obtaining and using these without medical advice.
PLWHA should be
- Counseled to consume a balanced diet.
- Encouraged to increase their energy intake by 10% if they are asymptomatic or by 20 30% if
they are symptomatic and without co- morbidities. If clients have co-morbidities refer
them to a dietitian.
- Referred to a dietitian if they fall in the vulnerable population groups (elderly, adolescents,
children, pregnant women etc).
- Counseled to increase the frequency or number of times they eat per day (i.e. have small,
frequent meals)
- To enhance their diet by using nutrient-rich foods
- To increase consumption of fruits and vegetables
- To increase consumption of foods fortified with the essential nutrients such as vitamin A,
iron, the B vitamins, and vitamins K and E.
- To use locally available foods to diversify their diets
- Encouraged to keep exercising regularly
- Advised to identify and monitor symptoms or conditions that affect their appetite or ability
to eat.
- Encouraged to check their weight periodically and if possible they should have necessary
laboratory tests.
4.2 Nutrition Screening
Nutrition screening and nutrition assessments are methods used to identify nutritional needs of people.
Nutrition screening is a rapid and economical way of identifying people at risk for poor nutrition. Tools
for nutrition screening can be administered by most service providers because they do not require high
skill level in nutrition. Typically, screening tools are designed to identify people with symptoms that are
suggestive of poor dietary intake, presence of an illnesses or condition that may precipitate
malnutrition. Common examples of people who are likely to be found at risk for poor nutrition include
those with poor appetites, gastrointestinal symptoms that might affect nutrient absorption or oral
symptoms that might interfere with food intake. PLWHA found at high risk for poor nutrition through the
use of nutrition screening tools should be referred to a dietitian for more extensive nutrition
assessment while those with low scores should be assisted using information in the relevant sections of
these guidelines.
Several screening tools are available for use. Some screening tools can be completed by PLWHA
themselves or with the help of the providers. Examples of nutrition screening tools include the Quick
Nutrition Screening and the subjective global assessment tool. The most commonly used screening tool
for PLWHA is the Subjective Global Assessment. This screening tool is preferred because it has been
used successfully before in people with wasting conditions. Amongst criteria found in screening tools,
unintentional weight loss of more than 10% of usual weight within 4-6 months, chronic infections
especially diarrhea and the presence of co-morbidities normally place PLWHA at high risk for poor
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