In many countries, a sizable proportion of the caseload of severely malnourished people found in inpatient facilities are HIV positive or otherwise affected by HIV/AIDS. The nutritional problems associated with HIV infection can severely limit the effectiveness of available treatment regimes and also have a strongly adverse impact upon people’s access to treatment and care programmes. Although the importance of nutrition in the treatment and care of people living with HIV/AIDS is now widely recognized, the practical implications of this insight have yet to be explored. There is an urgent need to explore the role of nutrition support in treatment regimes, to develop treatment and care programmes that deliver effective nutrition support and to differentiate between the use of therapeutic nutrition and the use of food as socio-economic support.
Drawing on our experience with treating severe acute malnutrition in children and on our work on the identification and treatment of adult malnutrition, Valid is pioneering the use of Ready-to-Use Foods (RUF) in the treatment of nutrition problems associated with HIV infection. RUF has great potential in this area: it is energy and nutrient dense, can be made with an appropriate balance of nutrients and it does not require cooking. Its high energy density means that sufficient calories can be delivered without the patient being expected to digest large bulky meals.
In developing countries the accepted method for providing support to people living with HIV/AIDS is home-based care (HBC). CTC/CMAM and HBC are closely related and share many common components, including emphases on physical care, a continuum of care, health education, local capacity-building, ensured access, sustainable support and community-based case-finding strategies. We are well-placed to apply tried and tested community nutrition delivery mechanisms within existing HIV/AIDS programmes.
