Food security status, dietary practices and nutritional status of people living with HIV and AIDS in Homabay town, Kenya

Type Thesis or Dissertation - Master of Science
Title Food security status, dietary practices and nutritional status of people living with HIV and AIDS in Homabay town, Kenya
Author(s)
Publication (Day/Month/Year) 2015
Abstract
The HIV and AIDS prevalence in Kenya is 7.2%. HIV and AIDS affect the
livelihoods of the PLWHA and consequently their food security status. The
country’s food security relies heavily on its agricultural production. Food insecurity
that influences dietary practices affects about 12% of Kenyans in urban households
and the presence of HIV and AIDS worsens the situation. There is limited data
available on the magnitude of food insecurity among PLWHA in Kenya and the
effect on dietary practices and nutrition status. The main objective of this study was
to assess the food security, dietary practices and the nutritional status of PLWHA
aged 18-55 years in Homa Bay town in Kenya. The study used a cross-sectional
analytical study design that allowed for the collection of both quantitative and
qualitative information at one point in time. The study adopted a sample of 333
PLWHAs that was drawn from a population of about 723 PLWHAs in Homa Bay
town and its immediate outskirts. Homa Bay town was divided into five and from
the list obtained from the clinic; proportion to size method was used to allocate the
sample to each village. Systematic random sampling method was used to select the
sample in each village at an interval of 3. A structured questionnaire was used to
collect data on demographic and socio-economic characteristics, food security
status, dietary practices and anthropometry. A focus group discussion guide was
used to collect more information. Data was analyzed using Statistical Package for
Social Sciences (SPSS) version 15.0. Analysis comprised of descriptive statistics
such as mean, percentages and frequencies. Chi square test was used to assess
relationships between categorical variables while Pearson correlation analysis to
establish the strength of association between non-categorical variables. Nutri-survey
was used to analyze dietary intake data from the 24-hour recall. Body Mass Index
(BMI) calculator was used to convert anthropometric measurements to BMI. T-test
for independent samples was used to determine if there were significant differences
between the study variables for males and females. Significance levels were
determined at 95% confidence interval where a p-value of <0.05 was considered
significant. Qualitative data was summarized, coded and analyzed to establish
emerging themes. This study found out that 27.4% of the study population were
food insecure as indicated by household dietary diversity score (HDDS) of <5. The
mean HDDS was 4.72±0.11, which is an indicator of low nutrient intake. The intake
of energy, fat and selected micronutrients namely iron, zinc, vitamin A, B6 and C
was inadequate for >20% of respondents. About 19.6% were undernourished (BMI
<18.5). Results show that, 6.8% of the respondents self-reported to have been
affected by malaria, 0.6% by tuberculosis and 2.5% by pneumonia in the two weeks
preceding the study.There were significant relationships between HDDS and energy
(p=0.042), HDDS and micronutrients intake (p<0.05), energy intake and BMI
(p=0.029) as well as the relationship between HDDS and BMI (p=0.015). Results
also showed significant relationships (p<0.05) between the intake of vitamin A,
vitamin C, iron and zinc and absence of illness. The study noted moderate food
insecurity (27.4%) which correlated with poor dietary practices and poor nutritional
status. The study recommends scaling up of food and nutrition security interventions
in the region by the government and other stakeholders.

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