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

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Goals of nutritional care and support (slide 4)Lwanga and Piwoz (2001) identify the following goals of nutritional care and supportfor people living with HIV/AIDS:• Improve nutritional status by maintaining weight, preventing weight loss, andpreventing loss of muscle mass.• Ensure adequate nutrient intake by improving eating habits and buildingstores of essential nutrients, including carbohydrates, protein, importantantioxidant nutrients, and other vitamins and minerals necessary for thefunctioning of the immune system.• Prevent food-borne illnesses by promoting hygiene and food and water safety.• Enhance the quality of life by promptly treating infections and managing thesymptoms that affect food intake to minimize the nutritional impact ofsecondary infections when they occur.• Provide palliative care during the advanced stages of the disease.Components of nutritional care and support (slide 6)The three components of nutritional care and support are nutritional assessment,intervention selection and design, and follow up and review.Nutritional assessment: Why measure? (slide 7)Nutritional assessments of people living with HIV/AIDS are necessary because theyexperience changes in a) body composition (decreased weight and body cell massand even fat accumulation), b) morbidity status that may affect eating and foodutilization, and c) food intake. Nutritional assessment measurements are conductedto:• Identify and track body composition changes and trends to determine theeffectiveness of nutrition therapy in slowing the progression of disease43
• Offer tailored treatment and management based on the assessment results• Address concerns and fears about physical health statusBody measurements are increasingly used as screening tools in clinical trails.What to assess or measure? (slide 8)The following measurements are commonly used in nutritional assessments:• Measurement of body size or proportions, known as anthropometry (e.g.,weight, height)• Laboratory tests for blood sugar, lipids, cholesterol, protein, and micronutrientstatus (e.g., serum levels, Hb, B 12 )• Clinical assessment of symptoms and illnesses associated with HIV/AIDSinfection such as oral thrush and diarrhea, often appropriate in the absence oflaboratory facilities• Review of dietary history such as appetite, food habits, and stress or depressionthat may affect eating• Lifestyle practices such as smoking, drinking alcohol and caffeine, and usingdrugs that may affect food intake or utilizationAnthropometric measurements in HIV/AIDS (slide 9)The following anthropometric measurements should be conducted regularly withHIV/AIDS patients to assess and monitor body weight and composition:• Percentage change in weight or BMI (body mass index) over time to gaugewasting• Lean body mass measurement to establish the proportion of body compositionthat is muscle. Body cell mass is a comparison of weight and volume.44
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 48 and 49: SESSION 3 NUTRITION ACTIONS FOR PEO
Page 50 and 51: Required materials• LCD or overhe
Page 52 and 53: McDermott, AY, A Shevitz, T Knox, R
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
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1. How does poor food availability
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5. Will referrals and targeting of
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SESSION 5 NUTRITIONAL MANAGEMENT OF
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Required materials• LCD or overhe
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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.
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Recommended preparation• Be famil
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———. 1998. Randomised trial o
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LECTURE NOTES 6: NUTRITIONAL CARE A
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The stigma associated with HIV can
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of malnutrition, which increases th
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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
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Suggested reading materialsAgostoni
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LECTURE NOTES 8: NUTRITION AND HIV/
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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
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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
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Body Habitus ChangesMetabolic chang
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PurposeTo provide general nutrition
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Stages of HIV Disease andNutritionI
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IncreaseVitamin and Mineral IntakeS
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Lipodystrophy• Means fat maldistr
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PurposeTo introduce the constraints
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Effect of AIDS on Crop ProductionCr
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Pregnant and Lactating WomenFood an
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Session 5 Nutritional Management of
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Rationale, Cont.Importance of Manag
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Session 6 Nutritional Care and Supp
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Vulnerabilityof Women and Young Gir
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What Is Not KnownComparison of Nutr
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Purposeof Nutrition Care and Suppor
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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
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PurposeTo provide knowledge and ski
Page 344 and 345:
SIDE EFFECTS OF DRUGSaffectFOOD INT
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Nutrition and HIV/AIDS: A Training Manual - Linkages Project

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