Abstract:
Globally, there is an increasing number of Human Immunodeficiency Virus (HIV) positive individuals living with excess weight, presented as overweight (BMI: 25.0 – 29.9 kg/m2) or obesity (BMI ≥30 kg/m2). The type of Antiretroviral Therapy (ART) may influence weight gain and contribute to the burden of Non-Communicable Diseases. The gravity of obesity among People Living with HIV (PLHIV) receiving ART is not yet explained in Zambia in relation to gender, rural or urban communities. This study assessed the prevalence of obesity and intake of fruit and vegetables to explain obesity within the Zambian context.
Data collection & Analysis: The study was conducted between 26/10/2023 and 30/11/2023 using a cross- sectional design. Ethical clearance was obtained and all participants consented to the study. Using questionnaires, data was collected from seropositive adults above 18 years old. Participants were recruited on a daily basis from health facilities that provided services to a minimum of 300 registered HIV patients. We used Stata 18 SE (Stata Corp, College Station, TX, USA) for data analysis. Background participants’ characteristics were summarized using frequency and proportion for categorical variables while continuous variables were firstly checked for normality, if normally distributed then means and standard deviation were reported, otherwise, median and interquartile intervals were reported. The prevalence and corresponding 95% confidence intervals of obesity, fruit and vegetable consumption and salt intake were estimated for each sex and both. All analyses were adjusted for survey design features including clustering, sampling weight, and stratification.
Results: The study found that the mean BMI was 24.1 kg/m2; higher in females (24.9 kg/m2) than males (22.4 kg/m2). Over one tenth (10.8%) of the participants were obese. The proportion of those classified as obese was higher in urban (12.4%) than in rural areas (9.2%). In comparison, much more females (13.9%) were obese than men (4.5%). The majority (74.8 %) of respondents were not consuming enough fruits and vegetables, with little difference between males (76.9%) and females (73.8 %). The proportion of men consuming processed food high in salt content was higher (15.1%) than for females (11.7%). Similarly, more males (40.7%) than females (33.6%) were in the habit of adding salt to their food before eating or when they were eating.
Conclusions & recommendations: The limited consumption of fruits and vegetable and the high consumption of processed foods high in salt indicate a dietary challenge in the management of obesity for HIV positive patients. Intense health promotion focusing on benefits of fruit and vegetables, reduction of salt intake and incorporation of screening for overweight and obese individuals receiving routine reproductive health care services should be supported though policy. Those found to have BMI above normal should be advised about lifestyle changes in relation to medication and reproductive decisions.
