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

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PVO-USAID Steering Committee on Multisectoral Approaches to HIV/AIDS. 2002.Promising practices on multisectoral approaches to HIV/AIDS. Draft, October.Washington, DC.Shah, M, N Osborne, T Mbilizi, and G Vilili. 2002. Impact of HIV/AIDS on agriculturalproductivity and rural livelihoods in the central region of Malawi. Atlanta: CAREInternational.UNAIDS. 2002. The impact of HIV/AIDS. Fact sheet. Geneva. Available atwww.unaids.org.———. 2000. Socio-economic impact of HIV/AIDS in Africa. ADF 2000. Presented byAnita Alban and Lorna Guiness. Geneva: UNAIDS. Available at www.unaids.org.———.1999. A review of household and community responses to the HIV/AIDSepidemic in rural sub-Saharan Africa. Compiled by G Mutangadura, D Mukurazita,and H Jackson. Geneva.USAID. 2002. USAID’s expanded response to HIV/AIDS. Washington, DC.67
LECTURE NOTES 4: FOOD SECURITY COMPONENTS IN HIV/AIDSNUTRITIONAL CARE AND SUPPORT====================================================IntroductionThe food insecurity commonly faced by HIV/AIDS-affected households can make itdifficult for people living with HIV/AIDS to practice appropriate nutritional care andsupport. Service providers who understand a household’s specific food securitysituation, the constraints on care and support options caused by insufficient foodavailability and access, and the mechanisms to address these constraints can offerfeasible and more effective nutritional care and support interventions.Purpose (slides 2, 3)The purpose of this session is to give students an introduction to the constraintsposed by food insecurity on nutritional care and support for people living withHIV/AIDS and approaches to implementing this care and support in food-insecurecontexts. The session:• Describes the dimensions of food security• Outlines the relationship between HIV/AIDS and food insecurity• Describes the effects of food insecurity on nutritional care and support topeople living with HIV/AIDS• Discusses ways to implement nutritional care and support in the face of foodinsecurityFood security components and nutritional care and support (slide 4)68
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Regional Centrefor Quality ofHealth
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ACKNOWLEDGMENTSThis training manual
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ABBREVIATIONS AND ACRONYMSACCAIDSAN
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INTRODUCTIONThe coexistence of high
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ContentThe content is arranged in t
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The sessions can also be taught in
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OutlineContent Methodology TimingDe
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LECTURE NOTES 1: THE BASICS OF HIV/
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gradually weakened. The infected pe
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increase in HIV prevalence of 60 pe
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infection may have a rapid onset, l
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• Dot-blot immunobinding assayUri
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• 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 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 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
Page 108 and 109: SESSION 5 NUTRITIONAL MANAGEMENT OF
Page 110 and 111: Required materials• LCD or overhe
Page 112 and 113: LECTURE NOTES 5: NUTRITIONAL MANAGE
Page 114 and 115: Figure 2 Cycle of malnutrition and
Page 116 and 117: IV. Late symptomatic phase (full-bl
Page 118 and 119: The following symptoms may also neg
Page 120 and 121: • Enables greater food intake by
Page 122 and 123: EXERCISE 5=========================
Page 124 and 125: HANDOUT 5.1 Caring for symptoms ass
Page 126 and 127: 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
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SIDE EFFECTS OF DRUGSaffectFOOD INT
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