Kelly A, Mek A, Frankland A, Akunai F, Kepa B, Kupul M, Nosi S, Cangah B, Walizopa L, Pirpir L, Emori R, Worth H, Siba P M, Man W Y N
Papua New Guinea Institute of Medical Research, PO Box 60, Goroka, Eastern Highlands Province 441, Papua New Guinea.
P N G Med J. 2011 Mar-Jun;54(1-2):23-34.
The relationship between HIV (human immunodeficiency virus), food security and nutrition has become increasingly important to practitioners, policy makers and people living with HIV. In this paper we describe for the first time the connection between HIV and antiretroviral therapies, the extent of nutritional counselling for HIV-positive people and food security in Papua New Guinea (PNG). A total of 374 HIV-positive people who were over the age of 16 and who had been on antiretroviral therapy (ART) for more than two weeks were recruited from six provinces, using a non-probability, convenience sampling methodology. A subsample of 36 participants also completed an in-depth qualitative interview. Participants received nutritional advice when beginning ART which focused on three main domains, of which the first two were the most frequently mentioned: what foods to avoid; what foods to eat; and how frequently to eat. 72% of the sample reported that they had experienced an increase in their appetite. Of those who reported that their appetite had increased on ART 33% reported that they did not have enough food to satisfy hunger. People who lived in the capital city, Port Moresby, within the Southern Region of PNG, had significantly more difficulty with food security than those who lived in other regions of the country. Not having enough food was the third most commonly recorded reason for non-adherence to ART. Responses to the HIV epidemic in Papua New Guinea must also begin to address the phenomenon of food insecurity for people with HIV, in particular those who are receiving antiretroviral therapies and who live in the urban areas.
对从业者、政策制定者和艾滋病病毒感染者来说，艾滋病病毒（人类免疫缺陷病毒）、粮食安全与营养之间的关系变得愈发重要。在本文中，我们首次描述了艾滋病病毒与抗逆转录病毒疗法之间的联系，以及巴布亚新几内亚（PNG）为艾滋病病毒呈阳性者提供营养咨询的程度和粮食安全状况。采用非概率便利抽样方法，从六个省份招募了374名年龄在16岁以上且接受抗逆转录病毒疗法（ART）超过两周的艾滋病病毒呈阳性者。36名参与者的子样本还完成了一次深入的定性访谈。参与者在开始接受抗逆转录病毒疗法时会获得营养建议，这些建议主要集中在三个主要方面，其中前两个方面是最常被提及的：应避免食用的食物；应食用的食物；以及进食频率。72%的样本报告称他们的食欲有所增加。在那些报告称接受抗逆转录病毒疗法后食欲增加的人中，33%的人表示没有足够的食物来满足饥饿。生活在巴布亚新几内亚南部地区首都莫尔斯比港的人，在粮食安全方面比该国其他地区的人面临更大的困难。没有足够的食物是记录在案的不坚持接受抗逆转录病毒疗法的第三大常见原因。巴布亚新几内亚应对艾滋病疫情的措施也必须开始解决艾滋病病毒感染者面临的粮食不安全问题，特别是那些正在接受抗逆转录病毒疗法且生活在城市地区的感染者。
