Nutritional status among adolescents living with human immuno-deficiency virus on anti-retroviral therapy follow-up living in selected regions of Ethiopia: a mixed methods study

Bore, Meless Gebrie

Nutritional status among adolescents living with human immuno-deficiency virus on anti-retroviral therapy follow-up living in selected regions of Ethiopia: a mixed methods study

Bore, Meless Gebrie

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Publication Type:: Thesis
Issue Date:: 2024

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Field	Value	Language
dc.contributor.author	Bore, Meless Gebrie
dc.date.accessioned	2025-05-23T03:52:49Z
dc.date.available	2025-05-23T03:52:49Z
dc.date.issued	2024
dc.identifier.uri	http://hdl.handle.net/10453/187481
dc.description	University of Technology Sydney. Faculty of Health.	en_US.UTF-8
dc.description.abstract	Background: In Ethiopia, despite a decline in overall HIV prevalence, adolescents, particularly those living with HIV (ALHIV) on antiretroviral therapy (ART), remain at high risk of malnutrition. A systematic review revealed stunting and wasting among ALHIV in low- and middle-income countries. Due to rapid growth and low status, these adolescents face significant nutritional risks that increase their vulnerability to infections. Integrated nutritional interventions are crucial for improving health outcomes, yet comprehensive information to guide these efforts is lacking. This study aims to identify gaps in practices and provide recommendations for enhancing the nutritional status and care of ALHIV. Methods: The study comprised three interrelated sub-studies focused on nutritional assessment and management practices for ALHIV. The first sub-study employed a quantitative prospective design to assess how healthcare workers in Ethiopian ART units manage the nutritional status of ALHIV, concentrating on existing practices and protocols. The second sub-study utilized a predominantly quantitative approach, supplemented by a small qualitative component, to evaluate nutritional status, including 24-hour dietary recalls and influencing factors. The third sub-study adopted a qualitative descriptive design to explore challenges and experiences of ALHIV aged 16–19 years, including their perceptions of support from ART clinics. Data were analyzed using descriptive statistics, regression models, and reflexive thematic analysis. Results: The study highlighted significant challenges in the nutritional management of ALHIV on ART in Ethiopia. Key findings included high levels of thinness, acute malnutrition, and stunting among ALHIV. Although nutritional supplementation helped reduce thinness, persistent issues such as food insecurity and psychosocial problems remained. Factors like delayed ART initiation, food insecurity, and psychosocial challenges negatively impacted nutritional status. Male adolescents, older age groups, and those with opportunistic infections were at higher risk of poor nutritional outcomes. Qualitative data revealed gaps in nutritional screening and education, compounded by economic hardships and psychological barriers faced by participants. Conclusion and Recommendations: This study highlights critical issues in the nutritional care of ALHIV on ART in Ethiopia, revealing significant malnutrition and disparities in care practices. To improve outcomes, it is essential to implement advanced nutritional assessment tools, standardize nutritional counseling, and enhance training for healthcare workers. Addressing socio-economic barriers like food insecurity is vital, as is integrating mental health services into the care framework. Promoting dietary diversity, fostering collaboration among community and policy stakeholders, and conducting further research on nutritional practices will help meet the complex needs of ALHIV on ART, ultimately improving their health and well-being.	en_US.UTF-8
dc.format	Thesis (PhD)
dc.language.iso	en_US	en_US.UTF-8
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/187481/1/thesis.pdf
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	© 2024 Meless Gebrie Bore
dc.rights	au.edu.uts.lib/cph
dc.title	Nutritional status among adolescents living with human immuno-deficiency virus on anti-retroviral therapy follow-up living in selected regions of Ethiopia: a mixed methods study	en_US.UTF-8
dc.type	Thesis
utslib.copyright.status	open_access	*

Abstract:

Background: In Ethiopia, despite a decline in overall HIV prevalence, adolescents, particularly those living with HIV (ALHIV) on antiretroviral therapy (ART), remain at high risk of malnutrition. A systematic review revealed stunting and wasting among ALHIV in low- and middle-income countries. Due to rapid growth and low status, these adolescents face significant nutritional risks that increase their vulnerability to infections. Integrated nutritional interventions are crucial for improving health outcomes, yet comprehensive information to guide these efforts is lacking. This study aims to identify gaps in practices and provide recommendations for enhancing the nutritional status and care of ALHIV. Methods: The study comprised three interrelated sub-studies focused on nutritional assessment and management practices for ALHIV. The first sub-study employed a quantitative prospective design to assess how healthcare workers in Ethiopian ART units manage the nutritional status of ALHIV, concentrating on existing practices and protocols. The second sub-study utilized a predominantly quantitative approach, supplemented by a small qualitative component, to evaluate nutritional status, including 24-hour dietary recalls and influencing factors. The third sub-study adopted a qualitative descriptive design to explore challenges and experiences of ALHIV aged 16–19 years, including their perceptions of support from ART clinics. Data were analyzed using descriptive statistics, regression models, and reflexive thematic analysis. Results: The study highlighted significant challenges in the nutritional management of ALHIV on ART in Ethiopia. Key findings included high levels of thinness, acute malnutrition, and stunting among ALHIV. Although nutritional supplementation helped reduce thinness, persistent issues such as food insecurity and psychosocial problems remained. Factors like delayed ART initiation, food insecurity, and psychosocial challenges negatively impacted nutritional status. Male adolescents, older age groups, and those with opportunistic infections were at higher risk of poor nutritional outcomes. Qualitative data revealed gaps in nutritional screening and education, compounded by economic hardships and psychological barriers faced by participants. Conclusion and Recommendations: This study highlights critical issues in the nutritional care of ALHIV on ART in Ethiopia, revealing significant malnutrition and disparities in care practices. To improve outcomes, it is essential to implement advanced nutritional assessment tools, standardize nutritional counseling, and enhance training for healthcare workers. Addressing socio-economic barriers like food insecurity is vital, as is integrating mental health services into the care framework. Promoting dietary diversity, fostering collaboration among community and policy stakeholders, and conducting further research on nutritional practices will help meet the complex needs of ALHIV on ART, ultimately improving their health and well-being.

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