Journal of Reproductive Health, Gender, and HIV in Africa | 12 September 2008
Integrating Nutrition and Antiretroviral Therapy: A Review of Clinic-Based Food Support for Food-Insecure Pregnant Women Living with HIV in Sub-Saharan Africa
M, r, s, S, u, s, a, n, M, a, r, s, h, a, l, l, ,, J, e, a, n, J, o, h, n, s, o, n, -, D, i, x, o, n, ,, N, g, o, z, i, A, d, e, b, a, y, o, ,, T, u, n, d, e, O, l, u, w, a, s, e, u, n
Abstract
Food insecurity is a critical barrier to antiretroviral therapy (ART) adherence among pregnant women living with HIV in sub-Saharan Africa. Hunger can exacerbate medication side-effects and malnutrition, undermining maternal health and the prevention of mother-to-child transmission. Integrated clinic-based nutrition support is a potential intervention for this challenge. This review synthesises evidence on integrating nutrition support with ART services. It specifically evaluates the effect of clinic-based food support, such as pantries, on ART adherence among food-insecure pregnant women living with HIV in sub-Saharan African settings. A narrative review of published literature was conducted. Databases were searched for studies examining food support interventions within HIV care for pregnant and postpartum women in sub-Saharan Africa. Qualitative and quantitative findings on programme implementation, acceptability, and health outcomes were analysed. Integrated food and ART support was highly acceptable and addressed a key perceived barrier to adherence. A prominent theme was that programmes reduced the need for women to prioritise food-seeking over clinic attendance. One study noted a 25% increase in self-reported optimal adherence among participants receiving food parcels compared to those who did not. Integrating food support within antenatal and HIV care clinics is a feasible and potentially effective strategy for improving ART adherence among food-insecure pregnant women. It addresses a fundamental social determinant of health, supporting both virological suppression and maternal nutrition. Programmes should consider sustained integration of nutritional assessment and food support within routine HIV care for pregnant women. Further operational research is needed to determine optimal food basket composition, cost-effective delivery models, and long-term sustainability within public health systems. HIV, pregnancy, antiretroviral therapy, adherence, food insecurity, nutrition support, sub-Saharan Africa, integrated care. This review consolidates evidence on a key operational intervention, providing a rationale for integrating food support into standard HIV care for pregnant women to address a critical barrier to treatment adherence.