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“I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy

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Abstract

We evaluated the acceptability and use of macronutrient supplementation among HIV-infected pregnant Ugandan women receiving antiretroviral therapy in a clinical study (NCT 00993031). We first conducted formative research among 56 pregnant and lactating women to select a supplement regimen. Acceptability and use of the supplementation regimen (35 sachets of lipid-based nutrient supplements (LNS) and 4 or 6 kg of instant soy porridge for the household provided monthly) were evaluated among 87 pregnant women. Organoleptic assessments of LNS were favorable. Participants reported consuming LNS a mean of 6.1 days per week, and adherence to recommended consumption behaviors (e.g. frequency, quantity, not sharing) was >80 %. Few women reported negative social consequences of supplementation. The majority of participants also consumed most of the porridge intended for the household. In sum, LNS was acceptable and used regularly. Larger studies to evaluate physical and psychosocial consequences of LNS during pregnancy among HIV-infected women are warranted.

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Acknowledgments

The authors sincerely thank the women who have participated in the PROMOTE-Pregnant Women and Infants trial. We warmly acknowledge the dedicated PROMOTE study team, members of the Makerere University–University of California San Francisco Research Collaboration, the midwives at Tororo District Hospital. We also thank Sophie Mou for her help with data analysis and Grace Akello and Wilfred Olwortho for their help with data collection. The primary sponsor of the PROMOTE-Pregnant Women and Infants trial is the National Institute for Child Health and Human Development Grant # HD059454. This nutritional sub-study was supported by PEPFAR (President’s Emergency Plan For AIDS Relief), the Office of the Global AIDS Coordinator, and the Office of AIDS Research HD059454-03S1. SLY was supported by K01 MH098902 from the National Institute of Mental Health. The micronutrient Sprinkles for the formative phase were generously donated by Micronutrient Initiative. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

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Authors and Affiliations

  1. Division of Nutritional Sciences, Cornell University, 113 Savage Hall, Ithaca, NY, 14850, USA

    Sera Young, Barnabas Natamba, Lynn Johnson, Chloe Michel, Amy Zheng & Marion Robine

  2. Makerere University–University of California, San Francisco (MU-UCSF) Research Collaboration, Tororo, Uganda

    Flavia Luwedde, Dorcas Nyafwono, Ben Okia & Paul Natureeba

  3. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Beth Osterbauer & Diane Havlir

  4. Department of Medicine, Makerere University Medical School, Kampala, Uganda

    Jane Achan

  5. Center for AIDS Prevention Studies University of California, San Francisco, CA, USA

    Edwin Charlebois

  6. Department of Obstetrics, Gynecology, and Reproductive Sciences Organization, University of California, San Francisco, San Francisco, CA, USA

    Deb Cohan

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  1. Sera Young
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Correspondence to Sera Young.

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Young, S., Natamba, B., Luwedde, F. et al. “I Have Remained Strong Because of That Food”: Acceptability and Use of Lipid-Based Nutrient Supplements Among Pregnant HIV-Infected Ugandan Women Receiving Combination Antiretroviral Therapy. AIDS Behav 19, 1535–1547 (2015). https://doi.org/10.1007/s10461-014-0947-0

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