Critical Gaps in Nutritional Care for Adolescents Living with HIV: A Multi-Facility Study from Ethiopia

BackgroundAdolescents living with HIV (ALHIV) in Ethiopia face significant nutritional challenges affecting their health and ART outcomes. Increased energy needs, HIV complications, and socioeconomic barriers contribute to their vulnerability. Despite ART advancements, research on their nutritional care remains limited, and comprehensive guidance is lacking. This study assessed ALHIVs nutritional status, nutrition support in ART clinics, and strategies for improvement. MethodA two cross-sectional survey were conducted in ten public hospitals across Addis Ababa and Oromia regions, involving 384 ALHIV and 44 healthcare professionals. Healthcare workers were selected through purposive sampling, while ALHIV were recruited using proportionate random sampling. Data was collected using a pre-tested structured questionnaire with quantitative and qualitative components, administered by trained healthcare workers via the Kobo Toolbox program. ResultsNutritional assessments of ALHIV revealed that 24.2% were thin, 21.7% were stunted, and 34.9% were malnourished based on mid-upper arm circumference, with 19.4% experiencing severe acute malnutrition. Many adolescents faced food insecurity, which negatively affected their nutritional status and ART adherence. While most healthcare workers conducted basic nutritional assessments, the use of sensitive tools was limited. Only 36.4% assessed dietary intake, 27.3% evaluated food security, and 38.6% provided regular nutrition counseling. Healthcare professionals expressed dissatisfaction with the integration of nutrition services due to inadequate training and resource constraints. ConclusionThe study highlights significant gaps in nutrition support and malnutrition among ALHIV on ART in Ethiopia. Integrating nutritional assessments and counseling into routine ART care, enhancing healthcare worker training, and developing standardized nutritional guidelines are essential for improving outcomes. Addressing food insecurity and socioeconomic barriers through adequate resources and policies is also critical for better health outcomes. Further research is needed to understand the long-term nutritional needs of ALHIV.