While clinical care providers, program managers and other stakeholders increasingly recognize the critical importance of nutrition for the treatment of HIV and AIDS, interventions that link nutritional support to treatment are relatively new. The Academic Model for Prevention and Treatment of HIV/AIDS (AMPATH) initiated one such intervention in 2002 in western Kenya with a large scaleexpansion currently underway with the support of World Food Programme commodity donations, and fresh foods grown on AMPATH production farms. The intervention is designed to bolster nutrition security of the most vulnerable patients on antiretroviral regimens over a short period of time by providing supplemental household food rations. As with other forms of food aid, issues of enrollment criteria, targeting efficiency, and transitioning off support pose challenges to program design and implementation.
Increased caloric requirements for HIV-positive individuals, undesirable side effects of treatment that may be worsened by malnutrition (but potentially alleviated by nutritional support), and the consequent threats of declines in adherence and increased drug resistance, are all justifications for developing more and better nutrition interventions for individuals on ARV treatment. Such urgency applies to any context where malnutrition and high or rising HIV prevalence coexist.