Ready-to-Use Therapeutic Food for Management of Wasting in HIV Infected Adults: A Qualitative Investigation of Views and Experiences of Patients in Ethiopia

HIV infection and poor nutrition status are interlinked. HIV infected individuals are more vulnerable to malnutrition than the general population. Poor nutrition status in HIV infected individuals is associated with disease progression, increased morbidity and reduced survival even when antiretroviral treatment is available. Adequate nutrition is necessary to maintain the immune system, manage opportunistic infections, optimize response to medical treatment, sustain healthy levels of physical activity and support optimal quality of life in individuals infected with HIV. WHO recommends incorporation of nutritional care and support as an integral part of a comprehensive response to HIV/AIDS. Ready-to-Use Therapeutic Food (RUTF) is widely in use in management of wasting among HIV infected adults. In Ethiopia, there was paucity of data on adults’ views and experiences of RUTF though patients’ perceived values of use and perceptions on a service are important factors in treatment success. The objective of this study was to explore views and experiences of HIV infected adults treated with RUTF in Addis Ababa, Ethiopia, 2012. The study explored issues related with attitude, believes, perceived benefits of use, misuses and challenges related with RUTF use. Phenomenological qualitative study based on in-depth interview and focus groups discussion was conducted on purposefully selected sample of 23 HIV positive adults on RUTF treatment in Zewditu hospital and Woreda-7 health center. The data collected was audio recoded, uploaded into opencode and analyzed using themes emerged from the data during constant comparative analysis. HIV infected adults had positive attitude, perceived many benefits of use and experienced favorable outcomes of RUTF use. Intention to use RUTF was also high. However, patients encountered significant challenges associated with their use of RUTF. They experienced side effects, felt more stigmatized and discriminated, encountered problems during handling and transportation. RUTF misuse was practiced frequently and in variety of forms. Modification of the current formulation and its prescription protocol, systematic control measures, provision of comprehensive nutrition counseling, harmonization of RUTF and other HIV clinical care appointments; and assessment and training on nutritional counseling skills of the health workers should be considered.