Food Insecurity, Standard of Living and Nutritional Status of People Living with HIV/AIDS (PLHAs) on ART: Rural–Urban Differences

Background: Synergistic effect of malnutrition, food insecurity and poor standard of living pour significant changes and poor outcome in already compromised PLHAs due to increased financial burden as well as emotional breakdown.

Objective: To assess the nutritional status , food insecurity and standard of living (SLI) with rural urban differences and their association if any among the PLHAs who have been stablished with one year of treatment.

Methodology: A facility based cross-sectional study on PLHAs was carried out in tertiary care centre of western Maharashtra with a sample size of 246. Data was collected by means of pretested semi structured questionnaire after taking Institutional clearance. Strict confidentiality was maintained throughout the study.

Results: The mean age of the study participants was 43.37 years with majority (50.9% rural, 39% Urban) were secondary class educated. Only 20% of urban and 8.5% of rural had income above 10,000 per month. Maximum (48.2 %) of rural were doing heavy works (construction/agricultural) while majority of urban were unemployed (30.5%) followed by business (21%) work. 36.9% (Rural) and 28.6 % (Urban) had spouse positive for HIV status. Even after one year of treatment, only 36.9% rural and 41% urban PLHAs were having CD4 count above 500. 49.6% (Rural) and 46.7% (Urban) were food insecure while 27.7% (Rural) and 14.3% (Urban) had low standard of living. 36.2% (Rural) and 30.5% (Urban) were undernutrition with 51.8% (Rural) and 54.3% (Urban) having abnormal waist circumference. BMI Category had statistically significant association with SLI and food insecurity in urban participants while it was not statistically associated with rural participants.

Conclusions: Inspite of freely delivered ART for one year and majority having good adherence rate, there were actionable changes in nutritional changes among PLHAs of both rural and urban areas. Neglected factors like food insecurity and standard of living needs to given special focus to affectively crub the high incidence of undernutrition among them. Immediate long term measures need to be taken to provide them adequate food and basic amenities of life with secure Job status.