The health and nutritional status of HIV positive women (25-44 years) in Mangaung

[摘要] English: Human Immunodeficiency Virus infection causes Acquired Immune Deficiency Syndrome, whichhas caused millions of deaths, with more expected, particularly in developing countries like SouthAfrica, where poverty is a critical factor.The intake, digestion, absorption and metabolism of food and nutrients emerge as a vicious cycle.The undernourished HIV-infected individual develops micronutrient deficiencies,immunosuppression and oxidative stress, thereby accelerating disease progression. Symptomsinclude weight loss and wasting, with increased risk of secondary infections.A representative sample of 500 African women (25-34 and 35-44 years) from Mangaung in SouthAfrica's Free State Province participated in the study.Socio-demographic composition and physical activity levels were determined by questionnaire.Weight, height, circumference (waist and hip) and bioimpedance measurements were used tocalculate body mass index and fat distribution and percentage. Dietary intake was determinedusing a food frequency questionnaire, and nutrient intake was analysed. Biochemical nutritionalstatus was determined through blood samples.Socio-demographic characteristics indicated high unemployment rates. Significantly more HIVpositive than HIV negative young women had lived in urban areas for over ten years, and smokedand/or used nasal snuff. Few young women had no education, while more older women had onlya primary school or Grade 8-10 education. Significantly more younger and older HIV positivewomen headed their own households. No significant differences were found in housing conditions,room density and household facilities of younger and older HIV positive and HIV negative women Anthropometric results showed that approximately 50% of all women were overweight/obese.Most women had a gynoid fat distribution and were fat/obese according to fat percentage.However, young HIV positive women had significantly lower body mass index and fat percentagethan young HIV negative women. The entire sample had low physical activity levels.Median dietary intakes of energy, macronutrients and cholesterol were high, with young HIVpositive women having a significantly higher median energy intake than young HIV negativewomen. Low median intakes of calcium, total iron, selenium, fat-soluble vitamins, folate andvitamin C, but high median intakes of the B vitamins, were reported overall. Younger women withHIV had significantly higher intakes of calcium, phosphorus, potassium, and vitamins B12, D and Ethan young HIV negative women. Older HIV positive women had significantly lower intakes ofhaem iron, nonhaem iron and selenium than older HIV negative women.Although median values for most biochemical parameters were normal, younger HIV positivewomen had significantly lower median haemoglobin and haematocrit levels, while older HIVpositive women had significantly higher serum ferritin and lower transferrin values than their HIVnegative counterparts. Significantly more HIV positive younger and older women had lowhaematocrit values, while significantly more HIV negative older women had low serum iron andhigh transferrin concentrations. Compared to HIV negative women, younger and older HIV positivewomen had significantly lower median blood values for total lymphocytes and serum albumin, butsignificantly higher median blood levels of total serum protein. Plasma fibrinogen and seruminsulin concentrations were significantly reduced in young HIV positive women. Older HIV positivewomen had significantly lower total serum cholesterol values than older HIV negative women.Serum glucose and serum triglycerides did not differ significantly between HIV positive and HIVnegative women within both age groups.In younger and older women, increased serum total protein and decreased serum albumin wereassociated with HIV infection. In younger women, smoking and being unmarried increase the oddsof HIV infection, while in older women a higher education level and a decreased non-haem ironintake are associated with HIV infection. An adequate diet, nutritional counselling and active physical activity can improve immune function,quality of life and biochemical nutritional status. Dietary intake alone, however, may be insufficientto correct nutritional deficiencies in this poor community, and the role of food-based approachesand micronutrient supplementation merits further attention.Key words: South Africa; African women; HIV; socio-demographic status; anthropometry; dietaryintake; physical activity; iron status; metabolic profile

[发布机构] University of the Free State