title: Descriptive characteristics and health outcomes of the food by prescription nutrition supplementation program for adults living with HIV in Nyanza Province, Kenya.
abstract: BACKGROUND
  The clinical effects and potential benefits of nutrition supplementation interventions for persons living with HIV remain largely unreported, despite awareness of the multifaceted relationship between HIV infection and nutrition. We therefore examined descriptive characteristics and nutritional outcomes of the Food by Prescription (FBP) nutrition supplementation program in Nyanza Province, Kenya.
  
  
  METHODS
  Demographic, health, and anthropometric data were gathered from a retrospective cohort of 1,017 non-pregnant adult patients who enrolled into the FBP program at a Family AIDS Care and Education Services (FACES) site in Nyanza Province between July 2009 and July 2011. Our primary outcome was FBP treatment success defined as attainment of BMI>20, and we used Cox proportional hazards to assess socio-demographic and clinical correlates of FBP treatment success.
  
  
  RESULTS
  Mean body mass index was 16.4 upon enrollment into the FBP program. On average, FBP clients gained 2.01 kg in weight and 0.73 kg/m2 in BMI over follow-up (mean 100 days), with the greatest gains among the most severely undernourished (BMI <16) clients (p<0.001). Only 13.1% of clients attained a BMI>20, though 44.5% achieved a BMI increase ≥0.5. Greater BMI at baseline, younger age, male gender, and not requiring highly active antiretroviral therapy (HAART) were associated with a higher rate of attainment of BMI>20.
  
  
  CONCLUSIONS
  This study reports significant gains in weight and BMI among patients enrolled in the FBP program, though only a minority of patients achieved stated programmatic goals of BMI>20. Future research should include well-designed prospective studies that examine retention, exit reasons, mortality outcomes, and long-term sustainability of nutrition supplementation programs for persons living with HIV.
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Nagata
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America.
authors.forename: Sera L
authors.initials: SL
authors.lastname: Young
authors.affiliation: Family AIDS Care and Education Services, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Catherine
authors.initials: C
authors.lastname: Wamuyu
authors.affiliation: Family AIDS Care and Education Services, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Mary N
authors.initials: MN
authors.lastname: Armes
authors.affiliation: Family AIDS Care and Education Services, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Benard O
authors.initials: BO
authors.lastname: Otieno
authors.affiliation: Division of Epidemiology, University of California, Berkeley, Berkeley, California, United States of America.
authors.forename: Hannah H
authors.initials: HH
authors.lastname: Leslie
authors.affiliation: Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Madhavi
authors.initials: M
authors.lastname: Dandu
authors.affiliation: Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Stewart
authors.affiliation: Family AIDS Care and Education Services, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bukusi
authors.affiliation: Division of HIV/AIDS, University of California, San Francisco, San Francisco, California, United States of America.
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D015992:Body Mass Index; D005260:Female; D005527:Food, Fortified; D015658:HIV Infections / Q000178:diet therapy / Q000188:drug therapy; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012923:Social Class; D016896:Treatment Outcome