Nutrition Care Model for Nutritional Assessment and Dietary Counseling of Adults Living with HIV in India

A high prevalence of undernutrition (40%) exists among adults living with HIV (ALHIV) in India due to their increased metabolic demands. Diminished nutritional status in turn has been associated with increased risk of morbidity and mortality among ALHIV. Nutritional assessment and its management are an integral part of HIV care; however, no strategy exists for screening of undernutrition among ALHIV.

The nutrition care model has been developed for undertaking nutritional assessment by classifying the severity of undernutrition based on body mass index (BMI) and identification of early signs of undernutrition including anemia and hypoalbuminemia among ALHIV.

The model suggests energy and protein intake based on the BMI and indicates desirable body weight corresponding to a BMI of 21 kg/m². Based on these requirements, the portion size of each major food group is provided for individualized dietary counseling by frontline workers. ALHIV found with signs and symptoms of anemia, low hemoglobin, and serum albumin are referred to the nearest health facility. Large-scale operational research and field validation studies are planned to better understand the effectiveness of the model in improving the nutritional and clinical outcomes and the strengths and limitations as an operational tool in programmatic settings.