Researchers in Ethiopia studied 412 adults living with HIV who were taking HIV medications to understand how eating a variety of different foods affects their health. They found that about half of the patients weren’t eating enough different types of foods, which could make them more likely to get sick. The study discovered that people with less education, those living in larger families, and those with more advanced HIV were less likely to eat a diverse diet. The findings suggest that helping people with HIV eat better and more varied meals could be an important part of their overall health care.

The Quick Take

  • What they studied: Whether people with HIV who are taking HIV medications eat a variety of different foods, and what factors make it harder or easier for them to eat well
  • Who participated: 412 adults living with HIV in Northwest Ethiopia who were receiving HIV treatment at health clinics between February and March 2023
  • Key finding: About 53 out of every 100 HIV patients studied were eating a good variety of foods, while the other 47 were not eating enough different types of foods
  • What it means for you: If you or someone you know is living with HIV, eating a variety of different foods—including fruits, vegetables, grains, and proteins—may help keep the immune system stronger and reduce the risk of getting sick. This is especially important for people taking HIV medications.

The Research Details

Researchers conducted a snapshot study in Ethiopia where they asked 412 people with HIV about what they eat and other details about their lives and health. They used a questionnaire (a list of questions) to collect information during face-to-face interviews. The researchers then used computer programs to organize and analyze all the information they collected. This type of study is called a cross-sectional study because it takes a picture of a group of people at one point in time, rather than following them over months or years.

Understanding what people with HIV are eating and what makes it hard for them to eat well is important because good nutrition is a key part of HIV treatment. When people with HIV don’t eat enough variety, they may not get all the nutrients their body needs to fight infections and stay healthy while taking their medications.

This study was conducted at health clinics in a real-world setting, which makes the results relevant to actual patients. The researchers used a structured questionnaire, which means they asked everyone the same questions in the same way. However, because this was a snapshot study done at one point in time in one region of Ethiopia, the results may not apply to all people with HIV everywhere. The study also relied on people remembering what they ate, which can sometimes be inaccurate.

What the Results Show

The main finding was that 218 out of 412 patients (about 53%) were eating a good variety of different foods, while 194 patients (about 47%) were not eating enough variety. This means that nearly half of the people studied weren’t getting the nutritional diversity they need. The researchers identified several factors that made it less likely for someone to eat a varied diet. People who couldn’t read or write were much less likely to eat diverse foods compared to those with more education. People living in families of 4-6 members were actually more likely to eat diverse foods, possibly because larger families have more people to share food preparation and resources. Interestingly, people with more advanced HIV disease (WHO stages III and IV) were more likely to have undiversified diets, which is concerning because these patients need good nutrition the most.

The study also found that people’s jobs mattered—those who worked as housewives or drivers were more likely to have undiversified diets. This might be because these jobs don’t provide stable income or time for meal planning. The research suggests that multiple factors work together to affect what people eat, rather than just one single cause.

This research adds to existing knowledge that nutrition is a challenge for people with HIV in low-income countries. Previous studies have shown that people with HIV often struggle to eat well due to poverty, lack of education, and limited access to food. This study confirms those findings in the Ethiopian context and provides specific numbers showing how common the problem is.

The study was done in only one region of Ethiopia, so the results may not apply to people with HIV in other countries or even other parts of Ethiopia. The study only looked at people at one point in time, so we can’t know if eating habits change over time. The researchers relied on people remembering what they ate, which can be inaccurate. Additionally, the study couldn’t prove that one factor directly causes poor diet—only that certain factors are associated with it.

The Bottom Line

People with HIV should aim to eat a variety of foods including different colored vegetables, fruits, whole grains, beans, nuts, and protein sources (like eggs, fish, or meat) every day. Healthcare providers should help patients with HIV understand why diverse nutrition matters and provide practical advice on how to eat better foods within their budget. Communities and governments should work together to make nutritious foods more affordable and accessible to people with HIV, especially those with limited education or income. (Confidence level: Moderate—based on this study and supporting research)

This information is most important for people living with HIV who are taking HIV medications, their families, healthcare providers who treat people with HIV, and public health officials in countries with high rates of HIV. People without HIV may benefit from eating diverse diets too, but the urgency is greatest for those with HIV because their immune systems are already compromised.

Eating a more diverse diet may help people with HIV feel better and have more energy within a few weeks. However, the real benefits for immune system strength and preventing infections develop over months of consistent, varied eating. It’s important to make dietary changes a long-term habit rather than expecting quick fixes.

Want to Apply This Research?

  • Track the number of different food groups eaten each day (aim for at least 5-6 different groups: grains, vegetables, fruits, proteins, dairy/alternatives, and healthy fats). Users can check off each group as they eat from it throughout the day.
  • Set a daily goal to eat at least one food from each major food group. Start by adding one new food type to meals each week—for example, if someone usually eats only grains and one vegetable, they could add beans or eggs one week, then add a fruit the next week.
  • Weekly review of dietary diversity scores to identify patterns. Users can set reminders to try new foods and track which food groups they’re missing most often. Monthly check-ins can help users see progress and adjust their goals based on what’s working.

This research provides important information about nutrition for people with HIV, but it is not a substitute for personalized medical advice. If you are living with HIV, please work with your healthcare provider or a registered dietitian to develop a nutrition plan that meets your individual needs and works with your HIV medications. The findings from this study were conducted in Ethiopia and may not directly apply to all populations. Always consult with your healthcare team before making significant changes to your diet or treatment plan.