Undernutrition Among HIV-Positive Adolescents on Antiretroviral Therapy in Southern Ethiopia

Purpose: Adolescents living with HIV are vulnerable to undernutrition secondary to elevated nutritional needs imposed by growth spurt and HIV-infection. Yet, in low-income countries, evidence on the epidemiology of undernutrition among adolescents living with HIV is scarce. We assessed the prevalence and predictors of stunting and thinness among adolescents receiving anti-retroviral therapy (ART) in Hawassa city, Southern Ethiopia.

Methods: In this facility-based cross-sectional study, we enrolled 260 adolescents (10-19 years of age) living with HIV on ART in two public hospitals and three health centers. Anthropometric measurements, household food insecurity and dietary diversity were measured following standard approaches. Predictors of stunting and thinness were identified using multivariable logistic regression analyses and interpreted using adjusted odds ratio (AOR) with 95% confidence interval (CI).

Results: One-third of the adolescents were stunted, and 20% were thin. The prevalence of severe stunting (7.7%) and severe thinness (7.3%) was also high. Significant proportions of the adolescents (38.5%) were from food insecure households, and 28.1% had low or medium dietary diversity. Significant predictors of stunting were lack of food or financial support (AOR=2.71; 95% CI: 1.36-5.39); meal skipping (AOR=2.13; 95% CI: 1.16-3.91); recent history of opportunistic infections (AOR=2.25; 95% CI: 1.11-4.55) and disclosure of HIV status to the adolescent (AOR=1.88; 95% CI: 1.12-4.34). History of opportunistic infection was the only significant predictor of thinness (AOR=3.21; 95% CI: 1.54-6.73).

Conclusion: The burden of undernutrition among adolescents living with HIV is disturbingly high. Prevention of opportunistic infections promoting social support and discouraging practice of meal skipping may help to reduce the problem.