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

Infant feeding options and risks (slide 39)All pregnant women and adolescents should be counseled on infant feeding optionsand risks. HIV-infected women and adolescents should be informed about ways toreduce risk of HIV transmission to the infant and counseled on related infant feedingoptions and risks. HIV-infected mothers who choose to breastfeed should becounseled on how to make breastfeeding safer, and mothers who decide not tobreastfeed should know the options and risks of replacement feeding.For breastfeeding women who are at risk of malnutrition, programs should considerproviding nutritional support to prevent nutritional depletion, weight loss, anddisease progression, as well as to enhance the success of exclusive breastfeeding(the efficacy of this is now being studied). Refer to Session 7 for further informationon infant feeding and prevention of mother-to-child transmission of HIV.Medications and ARV therapy (slide 40)Medications used to treat HIV-opportunistic infections may result in negative drugnutrientinteractions or cause side effects. As access to ARVs increases, more womenwill be treated with ARVs to delay disease progression and reduce the risk oftransmission of the virus to their infants. Many ARVs and medications prescribed totreat opportunistic infections have side effects that may affect dietary intake. Theseside effects include nausea, vomiting, diarrhea, constipation, anorexia, and changesin taste.The side effects of medications should be managed to ensure continued food intakeand adherence to the medications (see Handout 5.1: Caring for SymptomsAssociated with HIV in Adults for details on managing common problems in HIVinfection). In addition, some food and drug-nutrient interactions have to be takeninto consideration, and proper counseling should be provided on the use of thesemedications by the pregnant or lactating HIV-infected woman or adolescent. Forexample, supplements containing iron and zinc should not be taken with theantibiotic Ciprofloxacin. Refer to Session 9 on the dietary management of food anddrug interactions for further details.151