Nutrition and HIV/AIDS: A Training Manual - Linkages Project

help young adolescent pregnant girls who may be HIV infected, at high nutritionalrisk, and at high risk for morbidity and mortality.What is not known (slide 26)As noted above, the increased energy needed during pregnancy and lactation forHIV-infected women is the same as for other infected adults (i.e. 10 percent duringasymptomatic infection and 20 percent-30 percent during symptomatic HIVinfection). It is still unclear whether the same applies to an HIV-infected pregnant orlactating adolescent girl. There are no current recommendations to increase proteinrequirements for the HIV-infected pregnant or lactating adolescent girl.Practical considerationsPregnancy and HIV have a negative synergetic effect on the immune function.• Both impose physiological stress on the body.• Both affect immune response in women, which increases their vulnerability toviral, bacterial, and fungal infections.• Both increase metabolism, which increases the requirements for energy,protein, and micronutrients.These demands superimposed on the HIV-infected pregnant or lactating woman oradolescent girl require regular nutritional assessments (described later) and earlynutrition interventions to individualize nutritional care and support.Research is needed to assess which nutrients are needed and in what amounts forthe HIV-positive pregnant or lactating woman or adolescent. Until there is clearguidance, the established nutrition requirements for a normal pregnancy andlactation and the recommended increases in energy intake as a result of HIVinfection should be followed. Additional individualized requirements could berecommended based on the nutritional assessment. Country guidelines for vitaminand mineral supplementation for pregnant and lactating women andrecommendations for the HIV-positive pregnant or lactating woman should beconsulted.138