Factors associated with dietary intake among HIV positive adults (18-65 years) at the Mildmay Center, Kampala, Uganda

Abstract

Introduction: Despite the internationally accepted recommendation for dietary diversity as a means to provide adequate nutrient intake for a healthy diet and achieving positive health outcomes such as reduced mortality (Michels et al, 2002 and James et al, 2004), little is known about dietary diversity and factors affecting it among People Living with HIV/AIDS (PLWHA) receiving care and support at The Mildmay Centre in Uganda.

Objective: To determine dietary diversity and factors associated with it among HIV positive adults (18 to 65 years) receiving care at the Mildmay Center, Uganda.

Methods: The study was descriptive and cross sectional in design with a sample size of 169 HIV/AIDS adult patients attending The Mildmay Centre that were selected consecutively on a walk in basis between October and December 2007. The data were collected using an interviewer-administered questionnaire including questions about their socio-demographic, economic, health status, 24 hour dietary recall and an individual dietary diversity score tool (FAO/Nutrition and Consumer Protection Division, version of May 2007) and focus group discussions. Descriptive statistics such as frequencies, proportions, means and standard deviation and cross tabulations followed by multiple logistic regression were employed in data analysis.

Results: The mean dietary diversity score of the study respondents was 4.99 (SD 1.37) with 62.7% of the respondents scoring at 5 and more food groups. The foods groups mainly consumed were staple foods and grains (96%); foods prepared with oil and fat (77%); beans, peas and lentils/legumes (73%); meats, poultry and fish (53%) and roots and tubers (51%). There was minimal consumption of vitamin A rich foods (10%) vegetables (15%) and fruits (21%). Further analysis of the study results identified that coming from the western region of Uganda was protective of low dietary diversity as compared to the North-Eastern region (OR 0.15, 95% CI 0.04-0.60) while having no a regular income (salary) and purchase of food as a main source of food posed a four and three -fold risk of having a low dietary diversity respectively (AOR 4.28 95% CI 1.53-11.98 & AOR 3.00 95% CI 1.06-8.51).

Conclusions and recommendations: More than half of adult clients (PHA’s aged 18 – 65 years) receiving care at The Mildmay Centre Uganda have a moderately adequate dietary intake but less than 20% consume vitamin A rich foods, vegetables and fruits. A regular source of income (salary) and having main sources of food as own gardens and food support, rather than purchase, allows one to have adequate dietary intake. Other socio-demographic characteristics and individual health related factors in this study were not associated with dietary diversity. The nutritional education provided by health care providers at The Mildmay centre should encourage patients to increase on variety of food groups consumed including vitamin A rich foods, fruits and vegetables. Health care providers should support patients without regular incomes (Salary) and those who purchase food as main source of food to grow own gardens and access food support so as to improve their dietary diversity and therefore intake.