Food security, nutrition and HIV/AIDS – overview and context in Bolivia

To explore the nutritional status and food security of people with HIV receiving ART in Bolivia, to develop a nutritional counseling and food assistance intervention. Sample 80 male and female adults attending two urban HIV clinics in Bolivia. Methods Diet and nutritional intake; household food security; socio‐economic characteristics, and; health and ART status and adherence. Results 85% of households were food insecure, 34% of them severe. Dietary intake was characterized by a slight deficit in total calorie and carbohydrate intake, very low protein intake, and very high fat intake. Deficiencies in micronutrient intake included calcium, folic acid, zinc, magnesium, iron, phosphorus, and the B complex vitamins. Percent body fat showed that almost two thirds of women were overweight and another sixth were underweight; over a third of the men were underweight and only a tenth were overweight. The study population experiences high household food insecurity and poor nutrition, resulting in both obesity and micronutrient malnutrition, especially among women. Interventions should be targeted at the household level and focus on significantly increasing protein and selected micronutrients intake, and moderately increasing carbohydrates and overall calories, while drastically reducing fats, all of which may have significant impact on nutrition, adherence and clinical outcomes.