A Cost–Benefit Approach
Chapter 11: Nutrition and HIV at the Individual Level
Many countries have recognized the importance of micro-nutrients in supporting the immune system in its fight against all kinds of diseases. For example, South Africa has a national program that provides vitamin A supplementation in schools. Vitamin A is particularly important for SSA as there is more likely to be a deficiency due to the type of foods eaten and the fact that the tropical sun increases the demand for vitamin A (Stillwaggon, 2006, pp. 34–5). In the HIV context we would expect vitamin A to be important as it is required for the production of T cells. In this chapter we look at some evidence of micro-nutrient deficiencies in HIV populations and report the results of an attempt to assess the effectiveness of supplementing vitamins in SSA. THE EXTENT OF MICRO-NUTRIENT DEFICIENCIES IN THOSE WITH HIV Semba and Tang (1999) report the extent of micro-nutrient deficiencies in various HIV populations and the percentages are shown in Table 11.1. In the United States, homosexual men and heterosexual adults have the lowest levels of micro-nutrient deficiencies, and IDUs from large inner cities have the highest. There are not many studies for developing countries, but the ones that do exist show that pregnant women are most at risk. Note that vitamin A in particular is deficient in HIV populations in developing countries and in some groups in the United States. THE EFFECTIVENESS OF MULTIVITAMIN SUPPLEMENTATION Fawzi et al. (1998, 2004) undertook a serious of studies of multivitamin supplementation of pregnant women...
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