HIV/AIDS and nutrition : A review of the literature and recommendations for nutritional care and support in Sub-Saharan Africa

The HIV/AIDS epidemic continues to have a devastating effect on sub-Saharan Africa. By the end of 1998, at least 34 million people living in sub-Saharan Africa had become infected with HIV, and some 11.5 million of these have already died. In 1998 alone, about 2 million Africans died from HIV/AIDS. The AIDS epidemic in Africa has created unprecedented morbidity and mortality in young adults, reduced life expectancy, and diverted scarce resources from other pressing development problems. The toll the epidemic has taken on women and children is particularly acute. Malnutrition has been an endemic problem in Africa for decades, complicated by a combination of factors, and more recently, by the impact of AIDS. It is estimated that about one-third of all children under 5 in sub-Saharan Africa are stunted and more than half suffer from some form of micronutrient malnutrition. Malnutrition is also common among adults in Africa, where more than half of all pregnant women suffer from anemia and much of the population is at risk for iodine deficiency. HIV/AIDS and malnutrition are inextricably interrelated. Research suggests that malnutrition increases the risk of HIV transmission from mothers to babies and the progression of HIV infection. In turn, HIV infection exacerbates malnutrition through its attacks on the immune system and its impact on nutrient intake, absorption, and utilization. Malnutrition also increases fatigue, and it decreases physical activity and work productivity of people living with HIV and AIDS (PLWHA).