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

Counselors should be aware of and in touch with relevant programs that cover thegeographic areas where they work. It is important to work with program managersoperating these services to agree on criteria for participation to ensure that elgiblebeneficiaries are referred. In some cases it may be necessary to establish a formallink between the nutrition services and livelihood or safety net programs to availreferrals; in other cases informal information exchange may suffice.Adjusting expenditure allocationsEven without external resources, households can often reduce the food securityconstraints impeding nutritional care and support to some extent. For example,household food expenditures can be reallocated to increase purchase of foodsenergy-rich foods needed by people living with HIV/AIDS or foods helpful formanaging symptoms (e.g., soft foods for oral thrush). The Minnesota InternationalHealth Volunteers community program in Uganda works with people living withHIV/AIDS to help them plan their food budgets. Emphasis is placed on increasing theproportion of energy- and nutrient-dense foods relative to staple foods that are notnutrient dense.Intra-household food allocation and behaviorsIntra-household allocation of food can limit the capacity of people living withHIV/AIDS to access the quantity and diversity of foods needed for effectivenutritional care and support. This is especially the case when poor householdschoose to allocate lower quantities or poorer quality food to people living withHIV/AIDS as a result of stigma, their poor productivity, or the perception thatspending resources on someone who will die soon is wasteful. Counselors andservice-providers can help facilitate changes in intra-household food allocation andemphasize the benefits of proper nutrition for people living with HIV/AIDS and theirfamilies and communities. Home-based care settings offer a strong opportunity forsuch interventions.Simple adjustments to household food practices can also enhance the capacity fornutritional care and support. Such adjustments include changing meal practices andschedules to accommodate more frequent feeding for people living with HIV/AIDS.87