Session 7: Session 7: Integrating Nutrition Integrating Nutrition Assessment, Counselling, and Assessment, Counselling, and Education into HIV and AIDS Education into HIV and AIDS Care Care Nutrition Management with HIV and AIDS: Practical Tools for Health Workers
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Session 7: Integrating Nutrition Assessment, Counselling, and Education into HIV and AIDS Care Nutrition Management with HIV and AIDS: Practical Tools.
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Session 7:Session 7:Integrating Nutrition Assessment, Integrating Nutrition Assessment, Counselling, and Education into HIV Counselling, and Education into HIV and AIDS Careand AIDS Care
Nutrition Management with HIV and AIDS: Practical Tools for Health Workers
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 2
ObjectivesObjectives
• Appropriately assess and counsel patients on nutrition and HIV
• Identify ways to integrate nutrition into HIV and AIDS care
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 3
Nutrition at Each Stage of HIV: Nutrition at Each Stage of HIV: Stage 1Stage 1
• Symptoms• No other infections• Generalised fatigue
• Nutrition Considerations• Healthy eating and hydration (drink fluids)• Nutrition assessment and education
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 4
Nutrition at Each Stage of HIV: Nutrition at Each Stage of HIV: Stage 2Stage 2
• Symptoms:• Some other infections, but still in good overall health• Weight loss (less than 10 percent of normal weight)
• Nutrition Considerations:• Continue efforts for Stage 1• Follow-up nutrition assessment• Address nutrition-related side effects• Prevent weight loss• Prescribe micronutrient supplements, if indicated
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 5
Nutrition at Each Stage of HIV: Nutrition at Each Stage of HIV: Stage 3Stage 3
• Symptoms:• More serious infections• Severe weight loss (greater than 10% loss of usual
weight)• Chronic, unexplained diarrhoea for > 1 month• Unexplained anaemia
• Nutrition Considerations:• Continue efforts for Stages 1 and 2• Nutrition management for: weight loss/malnutrition,
ART, and infections• Coping strategies
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 6
Nutrition at Each Stage of HIV: Nutrition at Each Stage of HIV: Stage 4Stage 4
• Symptoms:• AIDS• More serious infections with life-threatening
complications• HIV Wasting Syndrome
• Nutrition Considerations:• Continue nutrition management of side effects, as
appropriate for client’s prognosis• Provide comfort and manage pain• Fluids for hydration
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Consider hospitalization with enteral, parenteral or supplemental feedings, treat infections, rehydrate, and promote weight gain with high calorie foods.
Treat symptoms/infection and prevent further weight loss and infections with high energy, protein, vitamin and mineral foods.
Follow up in 1-2 months
Follow up in 1 month
Nutrition Assessment Action PlanNutrition Assessment Action Plan
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 21
Integration of Nutrition into HIV Integration of Nutrition into HIV and AIDS Careand AIDS Care
• Begin at VCT services
• Address food availability and access
• Weight loss prevention can improve survival
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 22
First HIV VisitFirst HIV Visit
• Complete full nutrition assessment• Obtain baseline height and weight, calculate
BMI, and measure MUAC• Ask about recent weight loss or inability to eat
(due to illness)• Ask about food availability, food storage, and
cooking facilities in home• Provide nutrition counselling on healthy eating
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 23
Follow-up VisitsFollow-up Visits
• Continue with nutrition assessment
• Obtain height (if not already done), weight, calculate BMI, MUAC and % weight loss, if necessary
• Ask if any problems eating
• Ask if any change in food availability, storage or cooking facilities at home
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
Slide 24
For Patients in the HospitalFor Patients in the Hospital
• Take note of whether the patient is eating and how much
• If the patient needs help and family members are not there, provide help with eating
• Weigh patients• Counsel patient on adjusting food intake for
management of side effects
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
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Integration into ART ProgrammeIntegration into ART Programme
• Before ART, assess food availability and intake situation
• Assess weight status• Use Food and Medication Time Table when
discussing medication schedule• At each follow-up, obtain current weight and side
effects• Counsel appropriately on side effect
management and good nutrition
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training
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Integration into PMTCT and Integration into PMTCT and Ongoing Paediatric CareOngoing Paediatric Care
• Counsel mothers and partners on all infant feeding options for PMTCT
• Support infant feeding choice
• Educate on dangers of mixed feeding
• Monitor growth and feeding of infant
• For infants on replacement feeding, educate on and monitor formula/milk supply and preparation
Session 7: Integrating Nutrition into HIV and AIDS CareNutrition Management with HIV and AIDS Training