Associated factors of diet quality among people living with HIV/AIDS in Ghana

Abstract

Introduction : Nutrition is a very important element of a comprehensive care for people living with HIV/AIDS (PLHIV), especially in resource-constrained settings where malnutrition and food insecurity are common. Dietary diversity is a useful indication of nutritional adequacy (diet quality) in people of all ages. An optimally diverse diet strengthens the body’s immune system. Objective This study aimed to assess diet quality and its associated factors among PLHIV. Methods A facility-based cross-sectional study design was employed to select 440 PLHIV from two hospitals in the Eastern Region of Ghana. Dietary intakes were determined using 24-hour recall. A stadiometer and bioimpedance analysis machine were used to obtain anthropometric and body composition data. Diet quality was assessed using FAO’s individual dietary diversity score (IDDS) as a proxy. SPSS version 20 was used for analysis. Odds ratios and ordinal logistic regression were used to identify factors associated with diet quality among the PLHIV. P-value was set at 0.05. Results Most of the PLHIV (73%) consumed from ‘Starchy staple” food group. Less than 20% of the study sample consumed ‘Fruits’ and ‘Vegetables’ (17% and 14% respectively) a day before the survey. The mean IDDS was 4.11 (SD=1.29). Overall, most of the PLHIV (56%) had medium IDDS which is equivalent to “diet needing improvement’, 14% had higher IDDS (good diet), whiles about 31% of the participants actually had poor diet (lower IDDS). Associated factors of diet quality were age (AOR=0.966: 95%CI: 0.936–0.997: p=0.031), married (AOR=4.634: 95%CI: 1.329– 16.157: p=0.0016), separated (AOR=0.0203: 95%CI: .036–0.994: p=0.049), and daily meal frequency (AOR=0.441: 95%CI: .478–1.948: p=0.020). Overall, the model accounts for about 20% of the variation in diet quality of the participants (pseudo-R square=0.196). Conclusion This study demonstrates that most of the PLHIV did not consume good diet which may have an implication on their immune system, which is already under attack by HIV, and probably emerging infections. Age, marital status, and meal frequency were the variables that predicted diet quality among the study participants.