0.4 Hiv-infected children  (Page 2/2)

In people with symptomatic HIV disease there are likely to be several overlapping processes taking place:

Reductions in food intake

This may be due to painful sores in the mouth. Fatigue, depression, changes in mental state and other psychological factors mayalso play a role by affecting a person's appetite and interest in food. Economic factors also affect food availability and the nutritionalquality of food. Side effects from medications can also result in lower dietary intakes that can cause weight loss associated with HIV/AIDS.

Nutrient malabsorption

Malabsorption accompanies the frequent bouts of diarrhoea that affect people with HIV as a result of various infections.It is also believed that HIV infection itself may cause nutrientmalabsorption.

Metabolic alterations

HIV infection results in increased energy and protein need as well as inefficient use and loss of nutrients. Changes in metabolismoccur during HIV infection from severe reductions in food intake as well as from the immune system's response to the infection.

When food is restricted, the body responds by altering insulin and glucagon production, which regulate the flow of sugar and othernutrients in the intestine, blood, liver and other body tissues. Over time, the body uses up its carbohydrate stores from muscle and liver tissue and itbegins to break down body protein to produce glucose. This process causes protein loss and muscle wasting.

Management of weight loss in HIV/AIDS is complicated by the fact that these three mechanisms are not mutually exclusive. Weightloss and wasting in people with AIDS may be the result of all three processes.

For the first two causes of weight loss and wasting, malnutrition can be reduced by treating the immediate sources of theproblem (e.g. oral thrush, mouth sores, other infections) and providing foods that are soft and well tolerated by the infected person. People withdiarrhea should take plenty of fluids or use oral rehydration solutions to avoid dehydration and replace the lost fluids in the body. Also, if possiblepeople with symptomatic HIV should try to eat as frequently as possible, even if the amounts of food are very small each time.

Nutrition is an essential part of any HIV care package. Nutritional care and support includes many components, and particularlywhen a person is asymptomatic, it must include an adequate quantity and quality of food. But improved nutrition is not enough in itself topermanently keep people healthy. History provides evidence of this, as in the late 1980s many people with HIV in the United States and other countries,developed opportunistic infections, progressed to AIDS and died, even though they had an excellent diet. However, good nutrition may help prolongthe period of time between HIV infection and the onset of OIs.

In some communities affordable food supplementation may be feasible and it can have a positive impact on both body composition andweight. For example, The AIDS Support Organisation (TASO) has been distributing food to clients for 10 years as part of an overall communityoutreach response in Uganda.

With regard to vitamins and minerals, it is unclear to what extent these are helpful in the early stages of HIV infection. Severalstudies have been published on the role of vitamins and mineral in HIV disease progression and mortality. Primary associations were initiallypromising and micronutrient supplementation has the potential in a resource poor country to be an affordable and relatively easy to deliverpublic health measure. But the findings from micronutrient supplementation trials have however been mixed.

(For reading source, click here .)

Impure water

Those infected with HIV should make every effort to ensure that the water they drink is pure. As an individual infected with theHIV virus, one's immune system is more susceptible to contracting various infections and other diseases. Impure water is a source of where suchinfectious diseases may travel or originate; thus, it is ideal that HIV infected persons and AIDS patients drink water that is pure and free of suchbacteria.

Contact with animals

As is the case with impure water, animals are carriers of various diseases and infections that HIV/AIDS patients are moresusceptible to because of the weakness of their immune systems. As a result, it is in the best interest of such infected persons to be aware of the animalsin their surroundings. Be sure not to exchange any bodily fluids with animals and to be aware of meats consumed. Again, it is not necessarily thatyou may contract HIV from the animals; it is the fact that they may carry various diseases and infections that you are likely to contract if you comein contact with them.

Guidelines for hiv infected and affected children

Guidelines

Guidelines ( PDF )

Please see the PDF file above for reference information on the wonderful organization who has provided theseguidelines. The publications are designed for use by volunteer counselors, non-professional counselors, and professional counselorswho do not extensive experience in counseling in the context of HIV and AIDS.

The guidelines are the result of workshops organised under the SAT (School Without Walls), brining together professionalcounselors, people living with HIV or AIDS, staff of AIDS Service Organizations and people working in the field addressed by thepublication. Much of this information came from a workshop on counseling children with HIV or children affected by HIV and AIDS, facilitated byJonathan Brakarsh and Clare Rudd of the Family Support Trust (FST) fo Zimbabwe. These guidelines reflect the experiences of the counselors andactivities who participated. Virginia Knight Tyson and Sarah Lee provided editorial assistance. Joel Chikwara drew the cartoons.

To date, SAT has publisehd counseling guidelines in English and Portuguese on the following subjects:

• Disclosure of HIV Status
• Child Sexual Abuse
• Palliative Care and Bereavement
• Domestic Violence
• Survival Skills
• Basic Counseling Skills

SAT is a project of the Canadian International Development Agency delivered by the Canadian Public Health Association.It has been at the forefront in supporting the community response to HIV and AIDS in Southern Africa since 1991. School Without Walls is an intiative tovalidate, promote and diffuse souther African experience and expertise in responsing to HIV and AIDS.