Food and HIV: Media Briefing for World AIDS Day (1st December)
Overview
There has been huge progress against the HIV epidemic in the last 30 years. Globally, the number of new
infections has fallen and more than eight million people are on anti-retroviral (ARV) treatment. The drugs
available today have given thousands of people their lives back, enabling them to work, bring up their
children and play a full role in society.
However as food prices rise, people in developing countries are increasingly struggling to afford the
balanced diet that is fundamental to the success of ARV treatment.
CAFOD’s campaign ‘Hungry for change’ highlights the plight of the 870 million people around the world who
do not have enough to eat. Unfair systems hurt the poorest and most vulnerable whether they need food or
access to HIV services. Those people who lack adequate food AND are HIV positive have a double challenge.
The rising price of food has put a balanced diet beyond many of the world’s poorest people and is hitting
those reliant on ARVs hardest.
Many people and governments think that now that HIV drugs are more effective and more easily available,
we have done enough to tackle the epidemic. There were voices at this summer’s international AIDS
conference in Washington saying we have reached “the end of AIDS”.
But this is unfortunately far from true. Even for those receiving HIV treatment the drugs are not enough. For
the complex ARV drugs to work effectively, people need enough good quality food to eat. It is only then that
the vision of this year’s World AIDS Day: “Getting to Zero: Zero new HIV infections. Zero AIDS-related
deaths. Zero discrimination”, can be truly realised.
Why are HIV positive people hit hard?
People who are HIV positive are unable to absorb nutrients from food as effectively as those without the
virus. An immune system already under attack from virus is then further weakened by malnutrition which
can speed up the onset of AIDS-related illnesses for people living with HIV. Ill-health makes it more difficult
for the HIV positive person to work and so in turn undermines their ability to obtain a balanced diet.
Those taking ARV drugs need a good diet both to ensure that the drugs achieve the optimum effect, but also
because taking the powerful medication on an empty stomach leads to severe nausea. Taking the drugs
often leads to an increase in appetite as the person taking them starts to feel better, becomes more active
and thus needs more food.
Food availability and HIV– when the drugs don’t work
People with HIV require more food – an adult with the virus has on average a 10-30% higher energy
requirement than a healthy adult without HIV, for an HIV positive child the energy requirements are 50100% highera. A high energy diet supports the work of ARV drugs in the body, by allowing the body to burn
energy while utilise ARV drugs that help the body fight infections and build immunity. This diet is providing
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WHO – Nutrient requirements for People living with HIV/AIDS
Food security and HIV
the nutrition that an already weakened immune system needs and also enables that person to cope better
with the side effects of the HIV treatment medication.
Caroline Njeri Muthiga is CAFOD’s Senior Emergency Officer in charge of Nutrition, based in Nairobi:
“The relationship between nutrition and HIV&AIDS is complex. HIV infected people have higher
nutritional requirements than uninfected people. Malnutrition is one of the major complications of
HIV infection and a significant factor in advancing the disease.
“Malnutrition occurs when the body does not have enough required nutrients. It usually leads to
immune impairment thus compounding the effects of HIV and leading to faster progression of the
disease. Lack of food on the other hand, interferes with the body’s ability to absorb ARVs.
Insufficient food to accompany ARVs causes serious nausea, loss of appetite, leaves a metallic
taste in the mouth, increase diarrhoea, vomiting, and severe abdominal cramps.”
If people are unable to take their drugs properly this can have huge consequences both for the individual
and the HIV epidemic as a whole. ARVs demand an extremely high adherence rate, greater than 95%, to
work properly. For a twice daily regime, this means missing no more than three doses a month and sticking
to this regime year after year.
If there is poor adherence then there is a higher risk that drug resistance will develop, which will result in
the need for second line drug treatment. This can be more difficult to administer and the cost implications
considerable. If people living with HIV require second-line treatment, it can be ten times more expensive.
One CAFOD partner in Zambia described concerns over adherence to ARVs as a potential “time bomb”.
Mrs Kamene *(not real name) is a 32 year old mother of four children- 2 teenage girls and 2 young
boys aged 4 and 2 years respectively. She lives on her own as she is separated from her husband she
earns a living doing menial jobs that earn her just over a dollar a day (Kshs 100).
“It is very challenging to be HIV+ and to be on ARVs and to be taking care of four children and without
regular sources of food. I usually take my drugs at 8.00 a.m and 8.00 p.m every day. However, on
some days when I have not had anything to eat, I have had to stop taking them since they make me
feel dizzy, nauseated and generally very weak. But currently due to the work of the HIV/ARV support
groups, I have been taking my medication on a regular basis. But because I don’t have enough food in
the house, I sometimes take the medicines with porridge meant for my small baby. Taking ARVs on an
empty stomach makes you feel like you are dying.”
People with little food and income may have to choose between buying food or ARV drugs. Even when the
drugs are free many people live miles away from the nearest health clinic that is providing them. To get
regular check-ups and new supplies of the drugs, they are dependent either on public transport to get to
the clinic or a clinic worker travelling to see them.
Rising fuel costs mean that both these options become unaffordable or people are forced to sell their own
food. As Winefreda, 32, an HIV positive woman supported by a CAFOD partner in Zambia describes: “The
medication is free but our problem is how to get them – it’s a long walk for us. Sometimes we sell a chicken
to pay for the bus and come back to the house on foot.”
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Food security and HIV
HIV and food security – reverse effects
As well as food availability having an impact on HIV, HIV has an impact on food production. Not all those
living with HIV are able to lead as full a life as they would like. AIDS related illnesses can mean people are
unable to work and so can’t afford to buy food. For those who work on the land this means less food is
produced, affecting the whole community. Those affected by HIV are also impacted in the same way as
those infected; caring for a sick family member often means people have less time to earn money or
produce food.
Those treatment programmes that have the greatest levels of adherence in CAFOD’s experience are those
that give people food, as well as helping them earn a living.
Conclusion
Providing drugs alone is not enough to tackle the HIV pandemic. The issue of food availability and nutrition is
crucial in enabling people living with HIV to stick with their treatment. We have not nearly reached ‘the end
of AIDS’ and the links between food availability and HIV are a striking example of the challenges that remain.
The fear of not being able to get enough food to eat is deterring some people from starting ART and forcing
others to stop taking their medication. CAFOD’s Hungry for Change campaign is aimed at ensuring that
people living with HIV and their families are able to live healthier and better lives.
CAFOD believes that in the short term there is a need to see supplementary nutrition provided for people
with HIV and AIDS, but beyond that the cycle of poverty, drought and hunger must be broken to provide a
permanent solution to the problem.
Notes for editors

CAFOD has supported partners’ work on HIV and AIDS since the beginnings of the epidemic in the
1980s. Today CAFOD supports 58 partners in their work on HIV and AIDS, in Africa, Asia, Central and
South America.

The Catholic Church is in the front line of the global HIV battle, providing an estimated 25 per cent of
the care of people living with HIV and AIDS worldwideb. In many countries in Africa, faith based
organisations provide between 30-70% of the health care servicesc.

CAFOD is a member of the UK Stop AIDS campaign which this World AIDS Day is asking the UK
government: ‘Why Stop Now?’ The UK government has been a strong leader in the fight against HIV
and AIDS but the campaign calls on the government to develop a blueprint, mapping how the UK will
lead the global response in future, including maintaining investment in this area; and committing the
UK to reach all people affected by HIV and AIDS, regardless of where they live. The UK must target its
investment to where it is needed most, to continue the momentum and make a lasting difference. And
it must lead the way, ensuring other world powers do the same, and give their fair share.
b
c
Cardinal Javier Lozano Barragán, 2001)
http://www.capacityproject.org/images/stories/files/legacyseries_8.pdf
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