title: Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa.
abstract: OBJECTIVE
  Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults.
  
  
  METHODS
  In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups.
  
  
  RESULTS
  Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush.
  
  
  CONCLUSIONS
  Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults.
authors.affiliation: University of KwaZulu-Natal, Dietetics and Human Nutrition, Private Bag X01, Rabie Saunders, Scottsville 3209, Pietermaritzburg, KwaZulu Natal, South Africa. oketchja@gmail.com
authors.forename: Jecinter Akinyi
authors.initials: JA
authors.lastname: Oketch
authors.forename: Marie
authors.initials: M
authors.lastname: Paterson
authors.forename: Eleni Winfred
authors.initials: EW
authors.lastname: Maunder
authors.forename: Nigel Campbell
authors.initials: NC
authors.lastname: Rollins
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000178:diet therapy*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000517:prevention & control*; D009752:Nutritional Status; D011788:Quality of Life; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology