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

Issues and challenges for nutritional care and support of HIV-infectedpregnant or lactating women or adolescent girls (slide 41)Lwanga and Piwoz (2001) have identified a number of issues and challenges involvedin nutritional care and support of pregnant or lactation women and adolescents thatpolicymakers and health workers should address. First, although nutritionimprovement is likely to have its greatest impact early in HIV disease, most people,including women, do not know they are HIV-infected until they have advanceddisease (slide 42). This means a need for more accessible counseling and testingservices so that women can know their HIV status and deal with it earlier. Improvingaccess to treatment for HIV or opportunistic infections may increase willingness tobe tested for HIV.Stigma and discrimination continue to be problematic, especially for women, whofor social and cultural reasons may have less access to care and support servicesthan men (slide 43). Families are more likely to buy medication and care for illmales than females. Stigma, gender issues, and cultural constraints must beaddressed to improve care for women and their children.Access to food is one of the main challenges facing people living with HIV/AIDS inAfrica (slide 44). Food insecurity increases the vulnerability of women and younggirls to HIV infection as social status is diminished, thus compromising their ability tochoose safer and healthier life strategies. Lack of adequate food and nutritionsignificantly complicate the management of HIV/AIDS.The gender challenges of HIV, including women’s vulnerable social status and legalrights, must be faced (slide 45). In several countries studies have shown that ruralwomen whose husbands died of AIDS were forced into commercial sex to survivebecause they had no legal rights to their husbands’ property. This increases foodinsecurity and risk of malnutrition. Reversing the spread of HIV will require changesin women’s rights and empowerment.In most cases planting food crops is the responsibility of women (slide 46). AIDSaffectedhouseholds may plant less food or replace labor-intensive but nutritiouscrops with root crops that mature quickly but are less nutritious and profitable. Themove away from profitable or nutritious crops contributes to household food152