2. UNIT: 7 NUTRITION, HIV and AIDS Kamuzu College of Nursing Generic Year 1 2012-13 Lecturer Dr. Betty Mkwinda-Nyasulu

3. Aim of Unit 7.2The purpose of this unit is to provide students with basic knowledge about the links between HIV and AIDS and nutrition, the general nutritional needs of people living with HIV and AIDS (PLWHAs), and nutritional practices to slow the progression of HIV-infection to AIDS, and thus reduce morbidity and mortality.

4. Rationale Nutrition affects all body systems and disease state. Good nutrition enhances therapy of most important diseases. Good nutrition enhances therapy of most important diseases. Therefore understanding the relationship between HIV-infection, AIDS and Nutrition can help appropriate management HIV- infection and AIDS.

5. 7.3Specific objectives By the end of the unit, students will be able to: –Explain how HIV and AIDS affect Nutrition and how Nutrition affects HIV and AIDS 2. Describe HIV transmission through breastfeeding and make recommendations for making the feeding of infants and young children safer in the context of HIV 3.Explain recommendations for safer infant and young child feeding alternatives in the context of HIV. 4.Outline the goals of nutritional care and support for PLWHAs. 5.Explain factors to consider when planning nutritional care and support interventions for PLWHAs.

6. 7.0Introduction Malnutrition and AIDS –Relationship Nutritional status affect progression of HIV disease progression of HIV disease survival of HIV-infected people survival of HIV-infected people Malnutrition - danger for people living with HIV and AIDS (PLWHA)

7. Good Nutrition HIV demands body’s nutritional status- early stages - no symptoms HIV demands body’s nutritional status- early stages - no symptoms Malnutrition risk increases as the disease progresses. Good nutrition cannot prevent HIV-infection or cure AIDS Helps maintain & improve the body’s defense system Delay the progression from HIV-infection to AIDS.

8. Conditions Associated with HIV and AIDS food intake food intake digestion digestionabsorption. Symptoms e.g. diarrhea, weight loss, sore mouth and throat, nausea, or vomiting- Manageable with appropriate nutrition

9. Good nutrition  complement & enhance the effectiveness of any medication taken. NB** Nutritional care & support people with HIV and AIDS vary depending on NB** Nutritional care & support people with HIV and AIDS vary depending on 1. underlying nutritional status of an individual 2. stage of the infection or level of disease progression.

10. Relationship between Nutrition, HIV and AIDS 7.4.1The cycle of malnutrition and HIV Explain Figure 1: Malnutrition and HIV: A vicious cycle

11. Malnutrition and HIV negatively affect each other Weight loss, the most common and often the most disturbing symptom of HIV, reported in 95-100% of all PLWHAs. Loss of muscle tissue and body fat. Vitamin and mineral deficiencies. Compromised immune function. Increased susceptibility to opportunistic infections. Increased nutritional needs because of reduced food intake and increased loss of nutrients leading to rapid HIV disease progression.

12. 7.4.2 Synergistic effects of malnutrition and HIV Malnutrition and HIV affect the body in similar ways. Both conditions affect the capacity of the immune system to fight infection and keep the body healthy.

13. 7.4.3Effects of HIV and AIDS on nutrition HIV infection affects nutrition in three overlapping ways: inability to eat or swallow because of painful sores in the mouth and throat; loss of appetite as a result of fatigue, depression, and other changes in mental state; side effects of medications, including nausea, loss of appetite, a metallic taste in the mouth, diarrhea, vomiting, and abdominal cramps;

14. HIV interference with digestion & nutrients absorption Reasons: damage to the gut cells; increased incidence of opportunistic infections, such as diarrhea; poor absorption of fat, which reduces the absorption and use of fat-soluble vitamins such as vitamins A and E, and thus further compromises nutrition and immune status.

15. Exercise Activity 2 & 3 7.5.2 1.List factors that are likely to influence the nutritional status of people living with HIV and AIDS in the country. 2. Categorize them according to the following: Social factors Biological factors Programmatic factors

16. Goals of nutritional care and support for PLWHA include: Ensuring adequate nutrient intake necessary for the functioning of the immune system. Enhance the quality of life by maintenance of weight, prevention of loss of weight and muscle mass. Prevention of food-borne illnesses by promoting hygiene and food and water safety. Supporting the care of patients who are in the advanced stages of the disease.

17. 7.5.6Components of Nutritional Care and Support 1. Nutritional assessment 2. Intervention selection 2. Design and follow up and review.

18. Nutritional Assessment:Reasons Nutritional Assessment:Reasons Identify and track body composition changes and trends to determine the effectiveness of nutrition therapy in slowing the progression of disease Offer management based on the assessment results Provide counseling