HIV/AIDS, Undernutrition, and Food Insecurity
1Partners In Health, 2Brigham and Women’s Hospital, 3Center for AIDS Research, Harvard Medical School, 4Massachusetts General Hospital, and 5Friedman School of Nutrition Science and Policy and 6Fletcher School of Law and Diplomacy, Tufts University, Boston, Massachusetts
Despite tremendous advances in care for human immunodeficiency virus (HIV) infection and increased funding for treatment, morbidity and mortality due to HIV/AIDS in developing countries remains unacceptably high. A major contributing factor is that >800 million people remain chronically undernourished globally, and the HIV epidemic largely overlaps with populations already experiencing low diet quality and quantity. Here, we present an updated review of the relationship between HIV infection, nutritional deficiencies, and food insecurity and consider efforts to interrupt this cycle at a programmatic level. As HIV infection progresses, it causes a catabolic state and increased susceptibility to other infections, which are compounded by a lack of caloric and other nutrient intake, leading to progressive worsening of malnutrition. Despite calls from national and international organizations to integrate HIV and nutritional programs, data are lacking on how such programs can be effectively implemented in resource‐poor settings, on the optimum content and duration of nutritional support, and on ideal target recipients.
Received 4 February 2009; accepted 17 May 2009; electronically published 2 September 2009.
