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

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SESSION 3 NUTRITION ACTIONS FOR PEOPLE LIVING WITH HIV/AIDSPurposeThe purpose of this session is to provide students with general nutrition and dietaryguidelines to mitigate the effects of HIV on nutrition and reduce the progression ofHIV/AIDS morbidity, mortality, and related discomfort.Learning objectivesBy the end of the session, students will be able to:• Outline the goals of nutritional care and support for people living with HIV/AIDS• Describe the essential nutrition actions in the care and support of people livingwith HIV/AIDS• Explain factors to consider when planning nutritional care and supportinterventions for people living with HIV/AIDSPrerequisite knowledge• Knowledge of the principles of nutrition throughout the life cycle• Basics of HIV/AIDS in AfricaEstimated time: 60 minutes37
OutlineContent Methodology Timing1. Task 1 in Session 32. Goals of nutritional care and support• Maintaining or improving nutritional status• Ensuring optimal body composition forquality life and survival• Preventing diseases and diminishedimmunity3. Components of nutritional care and support• Assessing nutritional status• Designing and implementing appropriatenutritional interventions• Ensuring appropriate actions for the stageof illness, economic factors, and culturalsetting• Taking essential nutrition actions inHIV/AIDS to a) prevent weight loss, b)improve body composition, and c) improveimmunity and prevent infections4. Follow up and review: Importance ofrecording, integrated follow-up, and care ofopportunistic infections and other infections• Facilitate groupworkFacilitate aninteractive lectureusing PowerPoint 3presentationBrainstorm the roleof nutritional careand support forpeople living withHIV/AIDSBrainstorm methodsthat can be used fornutritionalassessment inHIV/AIDS10 minutes50 minutes5. Factors to consider when designing orimplementing nutritional care and supportinterventions• Social factors (stigma, social support)• Economic (household resources)• Clients rights• Quality of support (counseling,infrastructure, consistency)Summary of presentation by answering students’questionsAfter the lecture,facilitate group workto carry out Task 2 inExercise 3Capture discussionpoints on a flipchartor board30 minutes10 minutes38
Page 1 and 2: Regional Centrefor Quality ofHealth
Page 3 and 4: ACKNOWLEDGMENTSThis training manual
Page 5 and 6: ABBREVIATIONS AND ACRONYMSACCAIDSAN
Page 7 and 8: INTRODUCTIONThe coexistence of high
Page 9 and 10: ContentThe content is arranged in t
Page 11 and 12: The sessions can also be taught in
Page 13: OutlineContent Methodology TimingDe
Page 16 and 17: LECTURE NOTES 1: THE BASICS OF HIV/
Page 18 and 19: gradually weakened. The infected pe
Page 20 and 21: increase in HIV prevalence of 60 pe
Page 22 and 23: infection may have a rapid onset, l
Page 24 and 25: • Dot-blot immunobinding assayUri
Page 26 and 27: • Removal of children from school
Page 28 and 29: effectively, care and support inter
Page 31 and 32: DISCUSSION POINTS 1================
Page 34 and 35: Recommended preparation1. Be famili
Page 36 and 37: LECTURE NOTES 2: LINK BETWEEN NUTRI
Page 38 and 39: AIDS, the impairment of immune func
Page 40 and 41: for healthy, non-HIV-infected peopl
Page 42 and 43: Low blood levels of several nutrien
Page 44 and 45: • Finally, a study of AIDS patien
Page 46 and 47: EXERCISE 2=========================
Page 50 and 51: Required materials• LCD or overhe
Page 52 and 53: McDermott, AY, A Shevitz, T Knox, R
Page 54 and 55: Goals of nutritional care and suppo
Page 56 and 57: • Circumferences of the waist, hi
Page 58 and 59: Consider the phase of the HIV infec
Page 60 and 61: Promote adequate nutrient intake (s
Page 62 and 63: Stages of illness and symptoms. Sym
Page 64 and 65: TherapyNitrogenretention[g/day]Rate
Page 66 and 67: Nutrient supplements for people liv
Page 68 and 69: Conclusion (slide 31)Nutritional ca
Page 70 and 71: HANDOUT 3.1 Case studies in HIV and
Page 72 and 73: HANDOUT 3.2 Safe Food Handling Prac
Page 74 and 75: OutlineContent Methodology Timing1.
Page 76 and 77: Recommended preparation• Be famil
Page 78 and 79: PVO-USAID Steering Committee on Mul
Page 80 and 81: Nutritional care and support of peo
Page 82 and 83: In this session “food security co
Page 84 and 85: HIV/AIDS attacks food security not
Page 86 and 87: • Human capital: Reduced producti
Page 88 and 89: Food-insecure populations may also
Page 90 and 91: Food security constraints to nutrit
Page 92 and 93: Pregnant and lactating women (slide
Page 94 and 95: Implementation of nutritional care
Page 96 and 97: demand these foods. A good assessme
Page 98 and 99:
Counselors should be aware of and i
Page 100 and 101:
Conclusion (slide 36)The capacity t
Page 102 and 103:
UNAIDS and WHO. 2002. AIDS epidemic
Page 104 and 105:
1. How does poor food availability
Page 106 and 107:
5. Will referrals and targeting of
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SESSION 5 NUTRITIONAL MANAGEMENT OF
Page 110 and 111:
Required materials• LCD or overhe
Page 112 and 113:
LECTURE NOTES 5: NUTRITIONAL MANAGE
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Figure 2 Cycle of malnutrition and
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IV. Late symptomatic phase (full-bl
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The following symptoms may also neg
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• Enables greater food intake by
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EXERCISE 5=========================
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HANDOUT 5.1 Caring for symptoms ass
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Illness Diet Care and nutrition pra
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SESSION 6 NUTRITIONAL CARE AND SUPP
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OutlineContent Methodology Timing1.
Page 132 and 133:
Recommended preparation• Be famil
Page 134 and 135:
———. 1998. Randomised trial o
Page 136 and 137:
LECTURE NOTES 6: NUTRITIONAL CARE A
Page 138 and 139:
The stigma associated with HIV can
Page 140 and 141:
of malnutrition, which increases th
Page 142 and 143:
adolescent mother, growth and devel
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HIV infection increases the energy
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Anemia is common during HIV infecti
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The use of high levels of supplemen
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Nutritional care and support for th
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Management of secondary infections
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A. Nutrition history• Dietary int
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• Income, housing, amenities for
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multiple nutrient supplement, where
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Management of diet-related HIV prob
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Infant feeding options and risks (s
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insecurity and may increase malnutr
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Seumo-Fosso, E, and B Cogill. 2003.
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HANDOUT 6.1 Health Sector and Mater
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HANDOUT 6.2 A Guide to Nutritional
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• Educational levelLactating moth
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Did the counselor ask about: YES NO
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HANDOUT 6.4 Practical Consideration
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HANDOUT 6.5 Checklist for Nutrition
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HANDOUT 6.7 Dietary Management of C
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Dietary problemFeverNutritional int
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1. How could HIV infection affect R
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• Nutritional status, dietary int
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• Rita’s dietary intake and eat
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• Eating smaller, more frequent e
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• How was the nutritional assessm
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Estimated time: 120 minutes excludi
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Suggested reading materialsCoutsoud
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LECTURE NOTES 7: INFANT FEEDING AND
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• A viral, bacterial, or parasiti
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DNA (cell-associated virus) in colo
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Mucosal integrity (slide 18)Studies
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PMTCT interventions are most effect
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Breastfeeding techniquesIt is espec
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women with HIV/AIDS for additional
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• Providing skin-to-skin contact
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suitable for replacement feeds befo
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• Administration of ZVD and Lamiv
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Coutsoudis, A, et al. 2001. Are HIV
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Semba, RD, N Kumwenda, D Hoover, et
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Case study 1A school teacher, Regin
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• How would you respond to Hilary
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HANDOUT 7.2 PMTCT Decision-Making A
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OutlineContent Methodology Time1. E
Page 230 and 231:
Suggested reading materialsAgostoni
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LECTURE NOTES 8: NUTRITION AND HIV/
Page 234 and 235:
Despite these statistics, it is dif
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Etiology of growth failure among HI
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oys. Micronutrient deficiencies wil
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• Changes in eating behaviors ass
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• Address issues relevant and of
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Enhanced ARV therapy (slide 29)Chil
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• Refer children with severe maln
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DISCUSSION POINTS 8Questions for cl
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Action/activityNorman admitted to n
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OutlineContent Methodology Timing1.
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• Allocate time for each activity
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Food Medication Interactionswww.foo
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• Describes information collected
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• Antimalaria drugs such as quini
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Food effects on drug efficacy (slid
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Some antiretroviral drugs may affec
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MedicationPurposeRecommended Tobe t
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intake and poor nutrient absorption
Page 270 and 271:
Anti-acid medications containing ma
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women’s nutritional status. It is
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Health provider capacityHealth prov
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• What foods should not be taken
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Gelato, M. 2003. Insulin and carboh
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eferred him to the counselor for th
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Medication Purpose Recommended Tobe
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Medication Purpose Recommended Tobe
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Side effects of each drug?Side effe
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PurposeTo provide basic information
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Factors in Transmissionand Vulnerab
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Impact on the Education Sector• D
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AcknowledgmentNutrition and HIV/AID
Page 296 and 297:
Body Habitus ChangesMetabolic chang
Page 298 and 299:
PurposeTo provide general nutrition
Page 300 and 301:
Stages of HIV Disease andNutritionI
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IncreaseVitamin and Mineral IntakeS
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Lipodystrophy• Means fat maldistr
Page 306 and 307:
PurposeTo introduce the constraints
Page 308 and 309:
Effect of AIDS on Crop ProductionCr
Page 310 and 311:
Pregnant and Lactating WomenFood an
Page 312 and 313:
Session 5 Nutritional Management of
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Rationale, Cont.Importance of Manag
Page 316 and 317:
Session 6 Nutritional Care and Supp
Page 318 and 319:
Vulnerabilityof Women and Young Gir
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What Is Not KnownComparison of Nutr
Page 322 and 323:
Purposeof Nutrition Care and Suppor
Page 324 and 325:
Greatest Impact of NutritionImprove
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Size of the Problem in Africa• >3
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Possible Mechanisms ofTransmissionA
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Prevention-to-Care ContinuumInterve
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Session 8 Nutritional Care for Youn
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ChildrenBorn to HIV-Positive Mother
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Growth Failure Associated withIncre
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Enhanced ARV Therapy• To reduce v
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Care of the Terminally Ill ChildWhy
Page 342 and 343:
PurposeTo provide knowledge and ski
Page 344 and 345:
SIDE EFFECTS OF DRUGSaffectFOOD INT
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