title: Malnutrition in a population of HIV-positive and HIV-negative drug users living in Chennai, South India.
abstract: BACKGROUND
  Malnutrition is a strong predictor of poor outcomes in people living with HIV (PLHIV). Drug users are at increased risk of malnutrition regardless of whether or not they are infected with HIV. Little data exists on the nutritional status of drug users (with or without HIV infection) in India.
  
  
  METHODS
  We describe and compare the nutrition and metabolic status of 107 HIV-positive and 193 HIV-negative male clients of a community-based drop-in center for injection drug users in Chennai, India. Measures of nutrition and metabolic status include body composition, dietary intake, food insecurity, and serum lipid levels.
  
  
  RESULTS
  We found poor overall nutritional status in both the HIV-positive and HIV-negative clients, with HIV-positive men faring worse on some parameters. Both groups had extremely low percent body fat, but levels in HIV-positive participants were significantly lower (6.5% versus 7.9%, p=.01). HIV-positive men also had significantly lower total caloric and fat intakes compared to HIV-negative men. A considerable proportion (70%) of both HIV-positive and HIV-negative drug users were food insecure. HDL cholesterol levels were significantly lower and below normal range in the HIV-positive compared to HIV-negative men.
  
  
  CONCLUSIONS
  The high levels of food insecurity and poor nutritional status in this population, regardless of HIV status, indicates critical need for intervention. Improving nutritional status in those who are infected with HIV prior to initiation of antiretroviral treatment may help patients to reap the full benefits of therapy.
authors.affiliation: Tufts University School of Medicine, Department of Public Health and Community Medicine, Boston, MA 02111, USA. alice.tang@tufts.edu
authors.forename: Alice M
authors.initials: AM
authors.lastname: Tang
authors.forename: Tarun
authors.initials: T
authors.lastname: Bhatnagar
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Kimberly
authors.initials: K
authors.lastname: Dong
authors.forename: Sally
authors.initials: S
authors.lastname: Skinner
authors.forename: M Suresh
authors.initials: MS
authors.lastname: Kumar
authors.forename: Christine A
authors.initials: CA
authors.lastname: Wanke
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001823:Body Composition; D055030:Drug Users; D004435:Eating / Q000523:psychology*; D006678:HIV; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007194:India / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D009752:Nutritional Status; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D055815:Young Adult
chemical_list: D008055:Lipids