Food on the table: The role of livelihood strategies in maintaining nutritional status among ART patients in Kenya and Zambia

To build this evidence base, the Horizons Program, with the Overseas Development Institute and the International Centre for Reproductive Health, conducted a study to explore and understand the role that livelihood strategies play, in particular the ability of ART patients to achieve food security or adequate access to food. In addition to presenting findings from the study that explored the livelihood strategies of people on ART, this summary also presents recommendations on how to transition people on ART from therapeutic and supplementary feeding to sustainable, long-term livelihood security. A s understanding of the multidimensional nature of HIV epidemics improves, it is increasingly recognized that policy and program interventions, whether focusing on prevention, treatment and care, or impact miti-gation, must take into account the integral role of food and nutrition security. 1 More broadly, interventions need to consider how people's livelihoods evolve and adapt to deal with the multifaceted nature of HIV. HIV has implications for food and nutrition security , and in eastern and southern Africa, evidence pointing to a vicious cycle between HIV and food and nutrition insecurity is mounting. 2 Programs are now being implemented that link HIV to food and nutritional security, as well as to livelihoods. However, additional evidence on the effectiveness of these interventions, particularly as they relate to antiretroviral therapy (ART), is needed to inform policy and program efforts to improve treatment and to strengthen resilience to the impacts of HIV. Additionally, further insights are needed on how to move beyond the concept of therapeutic supple