The connection between food and HIV survival

The connection between food and HIV survival (this article originally appeared on the Toronto Star website http://thestar.blogs.com/worlddaily/2013/06/the-connection-between-food-and-hiv-survival.html

Three decades after HIV first emerged, the virus is no longer a death sentence. Thanks to antiretroviral therapy drugs, a newly-diagnosed 20-year-old can now expect to live for 50 more years.

But a new study by researchers in British Columbia underscores the fact that treating HIV has to do with more than just giving patients drugs — ensuring they are well fed matters too.

The study looked at the connection between food security and HIV survival rates, tracking 254 injection drug users across British Columbia over 13 years.

Roughly 71 per cent of those patients reported being food insecure when they first began their HIV treatments — and the study found that those patients were twice as likely to die.

“The introduction of life-saving antiretroviral therapy has significantly reduced HIV-related morbidity and mortality,” said senior author Robert Hogg in a press release. “However, the impact of insufficient access to food, particularly quality food, on the mortality of HIV-positive injection drug users is alarming.”

HIV/AIDS and food insecurity are “intertwined in a vicious cycle that heightens vulnerability to, and worsens the severity, of each condition,” according to this 2009 study.

There are many ways in which food insecurity can increase one’s risk of contracting HIV in the first place, the 2009 study notes. Surveys in Swaziland and Botswana have found that food insecure women are 80 per cent more likely to enter the sex trade and 70 per cent more likely to have unprotected sex. Food insecurity also leads to malnutrition, which can make people more susceptible to HIV infections by compromising their immune systems and “gut and genital mucosal integrity.” Otherstudies have also suggested that malnourished mothers are more likely to transmit HIV to their babies.

Food insecurity has also been linked with poorer drug effectiveness and lower adherence rates to treatment regimens. One paper cited in the 2009 study noted that HIV patients in Uganda receiving free drugs were still forced to choose between spending their money on transportation to clinics and using their limited funds towards feeding their children.

The 2009 study concluded that there is a growing recognition of how food insecurity impacts HIV survival rates but much more research is still needed to better understand the link.

Hogg notes that his study is only the first to examine the impact of food insecurity on HIV survival rates amongst injection drug users.

“The research points to the urgent need to further investigate the impact of food insecurity on the health outcomes of people living with HIV/AIDS,” he said in the press release.

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar

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Here I go Again!

Remember that motto of mine? “Have suitcase, will travel!” Well, here I go again…..

Where to you ask?

Gantsi.

It is the centre of Gantsi District and it’s claim to fame is that it is the furthest town from all other Botswana urban centers  The area is known for its indigenous peoples, the San. I am going to facilitate a strategic planning process for an organization that consists of a network of 8 NGOs whose goal is to empower these vulnerable people and assist them through economic development achieve permanent control over their lives, resources and destiny.

It was a very last minute thing – they required an experienced facilitator so WUSC asked me after striking out with other ODAs. I got the formal request on Friday, the sessions are this up-coming Saturday and Sunday. No pressure, huh? Oh, and by the way, Lawrence and I need to drive 900 kms to get there and another 900 kms back 🙂

So I spent yesterday working on a drafting a strategic planning exercise. I still haven’t finished it so I need to work on it tonight. I was out of the office all day today and will be out again tomorrow attending Governance training for my board. Can you say busy?????

But I am happy to be doing this as I am taking my buddy along to build his capacity in facilitating strategic planning or should I say he is taking me:) He has to drive as the vehicle is a standard and due to my wonky ankle, I can’t operate a clutch anymore.

I am also visiting a part of the country that I haven’t been to yet. We are staying a lodge that is owned and operated by the trust that I will be doing strategic planning for. The link to see it is http://www.dqae.org/ Of course it is a game area, with cheetahs and leopards. I am truly a mercenary as part of my negotiations to agree to doing this on such incredibly short notice, I asked that they arrange an evening game drive for us so that I can see the big cats at night when they are out and about.

So of course with a 1800 km road trip, indigenous people, game and who knows what else I will have plenty to blog about. My only problem is staying stationary long enough to be able to write 🙂

 

 

 

On A Serious Note

On my next blog posting I had meant to tackle the serious of topic of teenage pregnancy and sexually transmitted infections. I know! Thrilling topics but ones that are very important to the work that I am doing here in Botswana. Particularly after the meetings that I participated in last week.

In every one of the 30 District Health Plans that we reviewed the issue of rising rates of teenage pregnancy were identified.Back on my first trip to the Chobe District of Botswana that I made two weeks after arriving here four months ago, I attended my first DMSAC meeting (District Multi-sectoral Aids Committee). During this four hour meeting in a room with no air conditioning and baboons playing outside I got my first indications that teenage pregnancy was a major concern.

Last week my instincts were not only confirmed but backed up with district statistics. The M & E (monitoring & evaluation) side of me was blissfully happy!  Not that it was an issue but now that I had the data to support my concerns and a platform to leverage program change to address the issue. Could it get any better than that? Also in the room was the National Aids Coordinator from NACA who is responsible for coordinating civil society efforts within the government and National Strategy framework. Being typical Cheryl, I made sure that I secured agreement from him that this was a serious national issue and one that needed to be addressed by all levels of government and society.

He absolutely agreed with me and we are going to sit down next week to plan out our advocacy approach to secure Presidential support for a change in the National Strategic Plan. This is a big deal because 1) it is officially the President who has responsible for the National Strategic AIDS Strategy; 2) teenage pregnancy is about so much more than health issues. It is culturally, education, economic, gender, legal…I think you get the picture. Changing the ship’s direction (or Country’s) at this point in time is almost impossible. The National Strategy runs to 2016. The economy can not continue to support the escalation in costs to the health system that HIV and Aids requires. The President has been very clear about that and he is very correct.

I know, you are all thinking that makes it impossible odds. Actually, for me it makes it my focus. Oscar brought me to Bonaso to do and build capacity in advocacy. I have never met an impossible challenge that I backed down from and when it involves a generation of young women you can be guaranteed that there is no way in hell I am going to let this go. While I love my role as Organizational Development Advisor because every day I am using the varied and multiple skills that I felt were drying up in Canada. On any given day, I go from providing technical advice, guidance and creating systems in finance, human resources, data bases, governance, m & e, communications, strategic leadership, inter-agency collaboration, the list goes on. My absolute love is and always will be policy work, which includes advocacy for policy changes. Throw in the opportunity to make a difference or build capacity in gender issues and I am one truly happy camper. So stay tuned! I will keep you posted my progress and road blocks.

 

 

Ooops!!!

Well. I managed to behave myself relatively well for five days but by Thursday the real Miss Cheryl couldn’t help sneaking out.

We have been working very long days in teams of five reviewing the District Health Plans, which involves analysing the evidence and statistics on which the plans are based. Each planned activity is individually evaluated and agreement is achieved on how much funding to actually allocate to each activity if we have accepted to keep it as part of the District’s plan for health services in 2013-2014.

My team worked incredibly well together and were moving at a faster pace than any of the other teams. In fact, we had completed our quota of plans and were in the process of assisting another team by reviewing two of theirs. My only excuse for my behaviour can be that after spending four days in constant company of my team I could relax and be myself.

Part of our review process was to individually read the district profile and detailed activity plan making notes as we read to discuss with the group as whole. As I was reading I could not help myself when I came across the following planned item:

A family fun day which involved HIV/AIDS and TB testing, other health tests and the one that sent me over the edge – tests for cervical cancer. I am sorry but I would never consider any of these tests, particularly the HIV/AIDS testing or a pap smear FUN!  The thought of calling an event that revolved around this fun simply sent me into a major giggle fit. My colleagues wanted in on the joke so I explained as best as I could through the laughter…once I start one of these giggling fits, it takes a while for me to calm down. They quickly joined in and we all felt much better for a good laugh.

Oh, and by the way, we ended up approving funding for the event but I sincerely hope that the organizers decide to give it a more appropriate name!