Undernutrition and associated factors among people living with HIV under NACS assessment in Muchinga Province, Zambia, 2019-2020

IntroductionGood nutrition in People Living with HIV (PLHIV) has a good influence on treatment outcomes and in turn a better quality of life. Despite, the significant role it plays, many patients have limited access to Nutritional Assessment Counselling and Support (NACS). We evaluated undernutrition in people living with HIV and associated factors in Muchinga Province, Zambia, from October 2019 to March 2020. Material and MethodsThis was secondary analysis of routine program data of HIV-positive clients on ART enrolled at EQUIP-supported health facilities in Muchinga. Undernutrition was determined using body mass index (BMI) calculations and classified as undernutrition (<18.5 kg/m2), normal (18.5 - 24.9 kg/m2) or over-nutrition (overweight, 25 - 29.9 kg/m2 and obese, 25 - 29.9 kg/m2). Multivariate-adjusted odds ratios (aOR) were used to assess factors associated with undernutrition. ResultsOf the 506 eligible clients under NACS, the mean age was 34.9 years {+/-} 13.5SD, with 251 (approximately 50%) between the ages of 21 - 39 years. More than half (67%) were females, 284 (56%) were urban residents, and 180 (35.6 %) were unemployed. The majority (approximately 71%) were on the TLE regimen with a median duration on ART treatment of [~]3 years (IQR=1- 6). There were 233 (46%) who had a normal BMI, 191 (37.7%) who had under-nutrition, and 82 (16.2%) who had over-nutrition (9.7% overweight: 6.5% obesity). Clients in the urban area (aOR= 2.0; 95%CI: 1.28 - 3.1), unemployed (aOR= 2.4 (1.18-4.69)2.4; 95%CI: 1.18 - 4.69), married (aOR= 2.3; 95%CI: 1.26 - 4.38) and being on TLD (aOR= 2.8; 95%CI: 1.23 - 6.23) were more likely to be under-nourished. ConclusionNACS played a vital role in identifying HIV-positive clients who required more specialized care for improved clinical health outcomes. There is a need to strengthen HIV and nutrition integration in low-resourced countries with high HIV burden for improved treatment outcomes and quality of life.