Referred to as the “wasting disease,” HIV demands a far greater energy and nutrient intake to fight infection. The virus threatens the immune system, leaving its host emaciated.

With the double burden of malnutrition and HIV/AIDS, those in developing countries must decide between food or antiretroviral medications. According to the nutritionists at the World Food Programme (WFP,) many live in this “HIV-Hunger Trap.”

The WFP reports a prioritization of food over treatment.

Yet, those living with HIV/AIDS continue eat less than their healthy counterparts. Symptoms such as nausea, vomiting and sore mouth may affect appetite. The illness–as well as the medication for it–may “modify the taste of food and prevent the body from absorbing it.” The Food and Agriculture Organization (FAO) of the United Nations also cites exhaustion, depression and isolation symptoms.

These may limit energy to prepare and eat regular meals. And, in general, populations with high rates of HIV/AIDS lack sufficient access to food.

African nations affected the most depend on “labor-intensive farming systems.” Agriculture accounts for more than a third of these countries’ gross national product, reports the U.N. Yet from 1985 to 2011, AIDS led to death of seven million agricultural workers in 25 African countries. By 2020, the U.N. predicts HIV/AIDS could reduce the agricultural workforce by 25%.

This loss of the most productive age group (15 years old to 49 years old) results in greater food insecurity. Many households offer food and shelter to sick relatives or orphans, further limiting nutrient intake for each member.

HIV/AIDS also inhibits the ability to absorb food. Digestion breaks food into nutrients, and these nutrients subsequently provide energy and defense against infection. HIV and other infections, though, damage the gut wall. Consequently, food cannot pass through and be absorbed. Coupled with reduced food intake, this damage leads to severe weight loss and malnutrition.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) engineered a solution to the “HIV-Hunger Trap” in Lesotho. The country faces one of the highest prevalence rates, with 23.6% living with the virus. An estimated 28,000 children live with the dual threat of a weakened immune system and food insecurity.

The EGPAF aims to integrate nutrition education and support at local hospitals and health centers. At its “Nutrition Corners,” mothers and caregivers observe cooking demonstrations “using locally available fare such as sorghum porridge, beans, peas, vegetables and fruits.” This program also helps provide early treatment to HIV-positive children below the age of 2 years old.

Malnutrition serves as a gateway to infection for HIV-positive children.

At these hospitals and clinics, EGPAF monitors children to ensure proper weight for age and weight for height. If children fail to improve nutritionally for three visits, the foundation provides one-on-one counseling. Families who did improve participate in a group discussion. EGPAF also acts preemptively, providing caregivers and children of unknown status counseling. Testing services also offer an early diagnosis and access to treatment.

The HIV virus demands both medication and sufficient food intake. The World Health Organization recommends increasing energy intake by 50% to 100% for HIV-positive children experiencing weight loss. The Elizabeth Glaser Pediatric AIDS Foundation understands how impoverished regions fall into the “HIV-Hunger Trap.”

AIDS claims the lives of agricultural workers and those living with the virus subsequently face growing food insecurity. To meet the demands of this virus, the public health and agricultural fields can converge to protect vulnerable populations.

– Ellery Spahr

Sources: Elizabeth Glaser Pediatric Aids Foundation, Food and Agricultural Organization of the United Nations, United Nations
Photo: Joe McKay