Prevalence and factors associated with the minimum dietary diversity among HIV-positive women of reproductive age receiving anti-retroviral therapy in Kabale District

Abstract

Introduction: It has long been recognized that HIV causes malnutrition and malnutrition exacerbates the effects of HIV in the body. Women are physiologically, socially and economically vulnerable to HIV related malnutrition. FAO recommends women of reproductive age to consume at least five food groups daily; however, paucity of information exists about the diet quality of this population in Uganda, especially in Kabale district, which is among the chronically food insecure districts in Uganda. Objective: To determine the prevalence and factors associated with the recommended Minimum Dietary Diversity among HIV positive women of reproductive age (18-49) receiving ART in Kabale district. Methods: It was a cross sectional study, PPS sampling applied to select number of participants per HIV clinic and respondents were sampled consecutively in each clinic. A structured questionnaire was used to collect data on the respondent characteristics while the FAO’s IDD questionnaire used to collect the 24-hour dietary intake. Data were analyzed using both MS Excel 2010 and STATA version 14 software. Descriptive statistics were applied for univariate analysis. Modified Poisson was used to determine the factors associated with MDD. The study was approved by the Makerere University School of Public Health Review Board and informed consent obtained from the respondents before interviews. Results: The response rate was 99.2% and 90.9% of these were Bakiga. Their mean age was 34.8±8.1years, (47.6%) were married, and (98.0%) came from nuclear families with an average and median number of 4.4±1.9 and 4 members respectively. The mean number of food groups consumed was 4.7±1.7. The prevalence of the MDDS was 48.2%. The most consumed foods included: roots and tubers, pulses, dark leafy and vitamin A vegetables while milk, eggs and fruits were least consumed. Factors associated with MDDS at multivariate level included; age, type of employment, having nausea, viral load status and HIV clinical stage. Conclusions: Almost one half of the HIV positive women on ART in the district achieve the minimum dietary diversity and this can be contributed to being middle aged, having casual employment and unsuppressed viral load. Recommendations: Interventions should focus on nutrition education at every visit, focusing on those with nausea, suppressed viral load, HIV clinical stages 3 or 4 and the employed.