Predictors of undernutrition among reproductive age women (15-49 yrs) on antiretroviral therapy. Implications for antiretroviral treatment (ART) programs

Undernutrition among women on ART

Abstract

Background:  Human Immunodeficiency Virus (HIV) and malnutrition are interconnected in a vicious cycle, where each condition can independently cause progressive damage to the immune system. Evaluating the nutritional status of individuals on antiretroviral therapy (ART) is crucial, as it directly impacts the effectiveness and outcomes of ART, highlighting the need for integrated care to address both nutritional and medical needs.

Method: A cross-sectional study was conducted with randomly sampled Reproductive Age Women (15-49 yrs) on ART (n=268), to examine undernutrition and its predictors from February to May 2023. Data on socio-economic and demographic characteristics, nutrition-related factors, health indicators including CD4 count, WHO clinical stages, and opportunistic infections were collected. Frequencies, percentages, mean, and standard deviation were used, and binary and multiple logistic regressions were performed to examine associations between socio-demographic and predicting factors, with 95% confidence intervals and p-values <0.05 indicating statistical significance.

Result: Nearly 39% of reproductive age women on ART were undernourished (BMI < 18.5 kg/m2).  Women with no formal education (AOR=3.10(1.63, 7.60), advanced WHO Clinical stages (AOR=3.30(1.53, 7.11)), poor adherence to ART in past six months (AOR=3.43(1.78, 6.61), and food insecurity (AOR=2.10(1.25, 4.34) were significantly associated with undernutrition. Conclusion: Undernutrition remains a significant public health issue among reproductive-age women on ART. Key factors such as basic education for mothers, improving ART adherence, and addressing food insecurity are critical in tackling this problem. A controlled trial is recommended to better understand these factors and develop evidence-based interventions aimed at improving the nutritional and health outcomes of women on ART.