Food insecurity and coping strategies among people living with HIV in Dar es Salaam, Tanzania

Food insecurity and malnutrition seriously impedes efforts to control HIV/AIDS in resource poor countries. This study was carried out to assess food security, and coping strategies among people living with HIV/AIDS (PLHIV) attending Care and Treatment Centre (CTC) in Dar es Salaam, Tanzania. A structured questionnaire was used to interview randomly selected adults (≥18 years) who were HIV positive who have just been eligible for anti-retroviral treatment (ART) in a CTC or one who has started ART but not more than four weeks has elapsed. A total of 446 (females=67.9%; males= 32.1%) people living with HIV/AIDS attending CTC were interviewed. About three quarters (73.1%) of the respondents were 25-44 years old and most (43.9%) were married. Two thirds (66.7%) of the respondents had primary school education. Seventy percent reported to have a regular income and 63.7% with a monthly income of less than US$ 154. More than half (52.2%) of the respondents were food insecure. Food insecurity was similar in both males (54.6%) and females (51.2%). However, food insecurity was least (48.2%) among those who were single and highest (57.7%) among those cohabiting. Low level of food insecurity was associated with having completed primary education (Adjusted OR=0.27; 95%CI, 0.09–0.82) and high income (>US$154) (OR=0.10; 95%CI, 0.01–0.67). Reporting two or less meals increased the likelihood of food insecurity (OR=4.2; 95% CI1.7-9.8). Low frequency of meals was significantly more prevalent (18.6%) among those ≥45 years than among 35–44 years old respondents (6.7%) (P=0.04). Borrowing money (55.8%) and taking less preferred foods (53.3%) were the most common coping strategies. In conclusion, food insecurity is a significant problem among people living with HIV in Dar es Salaam which might significantly affect compliance to care and support. The study suggests that counselling of PLHIV before anti-retroviral treatment programmes should devise special strategies targeting those with low education, low income and low frequency of meals.