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

• Which coping strategies are having negative effects (e.g., sale of assets, riskylifestyle activities)?• What components need to be supported and built up and how?The objective of this process is to better understand the household’s food securitysituation, strategies to maintain or improve the situation, and opportunities that canbe supported or enhanced. Counselors need to broach these topics in addition todiscussing the clients’ health status to understand the sources of food insecurity andhelp clients identify and address these factors.Assessments focus on improving the counselor’s knowledge of client feedingpractices and of the underlying factors that could constrain or motivate the clientsto improve their diet. Understanding the specific nature of these factors is critical toprovide appropriate guidance and help clients identify feasible options fornutritional responses.Identifying gaps in access to key foods and nutrients (slide 30)An understanding of nutritional needs and food security constraints should make itpossible to identify foods and nutrients the client is not consuming in sufficientquantities because of poor access and availability. An effective assessment identifiesthese gaps and the causes of sub-optimal consumption. When lack of knowledge ordifficulty in eating as a result of HIV/AIDS symptoms cause low consumption,education and suggestions of new dietary practices to ease symptoms may besufficient to enable improved intake. In other situations poor food availability oraccess is the cause.Assessments will be client specific. Individual nutritional needs vary to some extentdepending on the stage of disease, medications taken, and opportunistic infectionsand symptoms. Reasons for failing to meet nutritional needs also vary. For example,an HIV-infected person or a caregiver may have access to relatively plentifulquantities of energy- and nutrient-rich food but be unaware of the need to eat moreof it. Another person infected with HIV may not be able to afford greater quantitiesof energy- and nutrient-rich food (which may be more expensive than less nutrientdensestaple foods). Still another may not have the status in the household to84