title: Sex differences in nutritional status of HIV-exposed children in Rwanda: a longitudinal study.
abstract: OBJECTIVE
  To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda.
  
  
  METHODS
  We applied a longitudinal design with three measurements 2-3 months apart among infants participating in a complementary feeding programme who were 6-12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns.
  
  
  RESULTS
  Among 222 boys and 258 girls, the mean (±SD) Z-score of stunting, wasting and underweight was -2.01 (±1.59), -0.15 (±1.46), -1.19 (±1.29) for boys; for girls they were -1.46 (±1.56), 0.22 (±1.29), -0.63 (±1.19); all sex differences in all three indicators were statistically significant (P < 0.001). However, there were only minor differences in early feeding practices and none in the ICFI by sex.
  
  
  CONCLUSIONS
  HIV-exposed male children may be at higher risk of malnutrition in low-resource setting countries than their female counterparts. However, at least in a setting where complementary foods are being provided, explanations may lie outside the sphere of dietary patterns.
authors.affiliation: School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
authors.forename: Jeanine U
authors.initials: JU
authors.lastname: Condo
authors.forename: Anastasia
authors.initials: A
authors.lastname: Gage
authors.forename: Nancy
authors.initials: N
authors.lastname: Mock
authors.forename: Janet
authors.initials: J
authors.lastname: Rice
authors.forename: Ted
authors.initials: T
authors.lastname: Greiner
mesh_terms: D001942:Breast Feeding; D004032:Diet; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000453:epidemiology*; D007227:Infant Nutritional Physiological Phenomena; D008137:Longitudinal Studies; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D012307:Risk Factors; D012432:Rwanda / Q000453:epidemiology; D012727:Sex Characteristics; D013851:Thinness / Q000453:epidemiology*
keywords: HIV; Ruanda; Rwanda; VIH; children; diferencias relacionadas con el sexo; différence entre les sexes; enfants; estatus nutricional; niños; nutritional status; sex difference; état nutritionnel