Perceptions of nutritional beliefs and behaviors of persons with HIV/AIDS

Prior research indicates that nutritional status is important in preventing opportunistic infections and probably in delaying the progress of HIV disease. Persons living with HIV/AIDS (PLWH/A) have identified that they want information about building their immune systems. However, information is sparse about their current beliefs and practices in nutritional support.

The purpose of this study was to identify nutritional beliefs and behaviors of PLWH/A. A grounded theory approach with constant comparison methodology was used to guide this qualitative study. Purposeful sampling was used to identify 28 HIV+ respondents on a Special Disease Unit in a private community hospital in a large southwestern city of the United States. Two audiotaped interviews were conducted for 22 of the participants with one interview in the hospital room and one in the home. Six other participants were interviewed only in the hospital. Observations were conducted at mealtime in the hospital and in three homes.

The core variable of Taking Charge was identified from the findings. Within this framework, PLWH/A used four strategies to manage their nutritional intake--Continuing, Exploring, Experimenting, and Committing. As PLWH/A moved from Continuing to Committing, they assumed increasing responsibility for their nutritional intake. Wasting and other changes in health status prompted PLWH/A to explore and experiment with new foods, different preparation methods and supplements. PLWH/A who perceived that their chosen foods and supplements were beneficial, committed to regular use. Their selection of specific foods was highly individualized and dependent upon available information.

Nurses should identify the present strategy and aim their care to support that strategy. A collaborative model, utilizing the skills of PLWH/A, nurses, and dietitians, should be developed to provide nutritional support for the strategies that PLWH/A use. Loss of appetite can occur at any time. Foods need to be readily available for this population.