Nutritional risk, food insecurity and quality of life in people living with HIV/AIDS in Paraiba, Brazil

Nutritional risk and food insecurity are related to insufficient or inadequate access to food. These conditions can be worse for people living with HIV/AIDS. Loss of appetite is one characteristic of increased nutritional risk. It is not known if food security itself has an impact on nutritional risk beyond the lack of access to food. The objective of this study was to evaluate nutritional risk and its association with food insecurity and quality of life in people living with HIV/AIDS and undergoing antiretroviral therapy in Brazil. A cross-sectional study was carried out in 2015 with 479 people living with HIV/AIDS in Paraiba state. Questions involving nutritional risk, food insecurity, quality of life, nutritional status and socio demographics were asked. Nutritional risk was the dependent variable and the chi-square test was used to test its association with the other study variables. The associated variables were included in the Poisson multiple regression model with a robust variance. 75.6% of the study sample were considered to be at nutritional risk. The adjusted model showed food insecurity (assessed as severe, moderate or mild using the Brazilian Food Insecurity Scale) and quality of life to have independent effects. The prevalence ratio (PR) of nutritional risk was 1.13 and 1.09 for severe food insecurity and moderate food insecurity respectively and no effect was observed for mild food security. Nutritional risk was less frequent in individuals with a higher score for quality of life (PR = 0.92). We conclude that people living with HIV/AIDS in Paraiba Brazil have a high prevalence of nutritional risk, seriously affecting their biological vulnerability. The prevalence of nutritional risk was higher among people with moderate or severe food insecurity, independent of socio-economic or occupational status. Policies are needed to strengthen social support to reduce the lack of food access for this population group, as are programs to promote food security and well-being. These could reduce nutritional risk and contribute to reducing morbidity and mortality for those with HIV/AIDS.