Magnitude, Determinants, and Coping Strategies of Food Insecurity Among People Living With HIV/AIDS in Eastern Ethiopia

Abstract

Background: Globally, over 2 billion people are affected by food insecurity linked to HIV/AIDS. In Africa, there are about 28.5 million people of all ages living with HIV/AIDS, of whom 2.2 million died of AIDS due to multiple factors that overlap, severe household food insecurity including inadequate food diversity, food intake less than three times a day, body mass index (BMI) of less than 18 kg per square meter, and inadequate food intake. Good nutrition is important for people with HIV because it helps strengthen the immune system and keeps people with HIV healthy and helps absorb HIV medicines. In sub-Saharan Africa, including Ethiopia, the high prevalence of starvation or famine exacerbated HIV/AIDS patients' mortality rates. National data from Ethiopia show that nearly 90% of HIV/AIDS-infected people are affected by food insecurity. The current study aimed to assess the magnitude, determinant factors, and coping strategies of food insecurity among adult people living with HIV/AIDS. Methods: An institutional-based cross-sectional study was conducted on 421 adult HIV positives who were attending antiretroviral treatment at public health facilities in both rural and semiurban areas. The study subjects were selected by a simple random sampling technique. A pretested, semistructured questionnaire was used. A bivariate and multivariate logistic regression model was fitted to identify the independent factors associated with food insecurity. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to measure the strength of the association. Results: Food insecurity was prevalent among 80.3% of HIV/AIDS patients in the study population. Living in a rural area, the presence of another family member with HIV, inadequate dietary diversity, low frequency of meals, and current high viral load in the last 12 months were some of the factors that significantly affect food insecurity among AIDS patients. Eating less preferred foods and reducing the number of meals were among common coping strategies. Conclusion: This study analyzed the overall magnitude of food insecurity among HIV/AIDS patients and found it to be higher, which may end up in a shortening of life expectancy. A national health policymaker needs to integrate long-term food and nutrition interventions for marginalized groups, specifically PLWHA to tackle factors negatively affecting food insecurity and highly erosive coping strategies among AIDS patients.

Keywords: East Ethiopia; HIV/AIDS; coping strategies; determinant factors; food insecurity.

Figure 1

Schematic presentation of the sampling procedure of study participants of food insecurity and coping strategies among people on ART follow-up, Eastern Ethiopia [19].

Figure 2

Level of food insecurity among adult people living with HIV/AIDS on follow-ups at public health facility of Hararge, Ethiopia. Dietary diversity, meal frequency, and nutritional status among adults on ART in public health facilities of Eastern Ethiopia (n = 421).