Sociodemographic factors affect the nutritional status of HIV-infected adults

November 21, 2001

Nutritional assessment is an often overlooked factor in the progression of HIV infection, although the relationship between nutrition and immune function is well established. Regardless of whether a diagnosis of acquired immunodeficiency syndrome (AIDS) has been made, nutritional status may predict long-term survival in HIV-infected individuals. In a cross-sectional study of 633 HIV-positive adults, Kim et al. examined sociodemographic factors that could influence their nutritional adequacy.

The study included 463 male and 170 female HIV-positive participants, ages 21-70, from the greater Boston and Providence, Rhode Island areas. The male subjects were 70% white, 20% African-American, and 7% Hispanic, and the female subjects were 41% white, 43% African-American, and 11% Hispanic. Obesity was not uncommon among the participants, especially among females: 20.6% were obese and 50% were overweight. A considerable portion of the population (21% of the men and 28% of the women) reported that they were currently dieting to lose weight.

When dieting subjects were excluded from the analysis, a number of sociodemographic variables emerged that affected the subjects' nutritional adequacy. Gay men were significantly more likely to meet the Recommended Daily Allowances (RDAs) for nearly all nutrients, perhaps because in general they had greater household incomes and educational attainment than the other groups. Patients with children living in the home, with lower household incomes and educational attainment, without a partner or caregiver living with them, or without assistance in food preparation and shopping were less likely to meet the RDAs for nutrients. Females and past or present users of injectable drugs were more likely to fall within these sociodemographic categories. HIV-positive or AIDS-diagnosed subjects who took protease inhibitors or antiretroviral drugs were more likely to have a nutritionally sufficient diet, possibly because these drugs are highly correlated with higher educational levels and private medical insurance.

The overall nutritional status of HIV-infected persons emerges from a wide range of attitudinal, economic, and lifestyle factors across a varied population. The authors conclude that, "Public health practitioners should strive to understand the reasons underlying food choices, food procurement, and eating practices in this population, which includes disproportionate numbers of individuals who are drug abusers, indigent, disabled, and homeless."
Kim, Jean H. The correlates of dietary intake among HIV-positive adults. Am J Clin Nutr 2001;74:852-61.

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