SEMINAR: The impact of a food assistance program on nutritional status, disease progression, and food security among people living with HIV in Uganda
Thursday, September 26, 2013 - 17:00 to 18:30
Speaker: Dr. Suneetha Kadiyala, Senior Lecturer in Nutrition-sensitive Development, London School of Hygiene & Tropical Medicine/ Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH).
Location: London International Development Centre (LIDC), Room 103 (Upper Meeting Room), 36 Gordon Square, London, WC1H 0PD
RSVP: Register (free)
This event is part of the 3ie-LIDC Seminar Series 'What works in international development'.
Although the last decade has seen increased access to anti-retroviral therapy (ART) across the developing world, widespread food insecurity and undernutrition continue to compromise an effective response to the AIDS epidemic. Limited evidence exists on the potential benefit of food security and nutrition interventions to people living with HIV (PLHIV). We capitalized on an existing intervention to HIV infected individuals in Uganda, to design and conduct a prospective quasi-experimental study evaluating the impact of a monthly household food basket, provided to food insecure ART naïve PLHIVs for 12-months. The outcomes of interest were nutritional status (body mass index (BMI); mid-upper arm circumference (MUAC), and hemoglobin (Hb) concentrations), disease severity (CD4 count), and two measures of food security: diet quality (Individual Dietary Diversity Score (IDDS)) and food access (Household Food Insecurity Access Scale (HFIAS)). We utilize difference-in-difference propensity score matching to examine the impact of food assistance. Food assistance significantly increased BMI by 0.6 kg/m2 (P< 0.01), and MUAC by 6.7 mm (P<0.05). We find no impact of food assistance on CD4 count, Hb concentrations, or IDDS. When restricting the analysis to individuals with CD4 counts >350 cells/μL, however, we see large significant impacts on Hb concentrations (1 g/dL; P<0.05). At the household level, food assistance improved food security as measured by the HFIAS, by 2.1 points (P<0.01). This study adds to the scant evidence base and demonstrates the potential for food assistance programming to be part of the standard of care for PLHIV in areas of widespread food insecurity.