Research consultancy
EFFECTS OF ANTIRETROVIRAL DRUGS ON NUTRITIONAL STATUS OF ADULT WHO HAVE BEEN ON DRUGS FOR 6-10 WEEKS AGED 18-50 YEARS
CHAPTER ONE
1.0 INTRODUCTION
This chapter presents the Background, problem statement, purpose, general objectives, specific objectives, research questions, Significance of the study, and scope of the study.
1.1 Back ground
The last two decades, HIV/AIDS has continued to spread across all continents causing the death of millions of adults in their prime age, disrupting and impoverishing families and turning millions of children into orphans, (UNAIDS, 2009).
HIV/AIDS affects the most productive segments of the populations, and the epidemic has thus tremendously reduced workforces and reversed many years of economic and social progress and has in some cases posed threat to political stability.
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS, 2009), there were about 39.5 million people living with HIV by the end of 2006. Out of these, 37.2 million were adults and 2.3 million were children below the age of 15 years. There were 4.3 million new infections in 2006. In Sub-Saharan Africa about 2.8 million people were infected with HIV and 24.7 million people were living with HIV. Despite recent improved access to antiretroviral treatment (ART) and care in many of the world’s regions, the epidemic claimed 2.9 million lives in 2006.
Although efforts have beenput in place to fight HIV/AIDS in Uganda, about 1million people are leaving withHIV/AIDS (MOH and ORC Macro, 2006). According to Uganda HIV/AIDS serobehaviouralsurvey (2004-2005), the prevalence of HIV among adults (18-59 years ofage) was 6.7 % and the prevalence is higher in Kampala district about 8.5 % thanother districts. The high prevalence of HIV/AIDS in this most productive age hasgreat impact on health, economic and social aspects.
The advent of potent Anti-Retroviral Treatment (ART) in 1996 led to a revolution in thecare of patients with AIDS in the developed world.
Although this treatment is notcurative and also presents new challenges with respect to side effects and drug resistance,it has dramatically reduced rates of morbidity and mortality, have improved the qualityof life of people with HIV/AIDS and have revitalized communities (3) Moreover,HIV/AIDS is now perceived as a manageable chronic illness rather than as a plague.Unfortunately, most of the 39.5 million people currently living with HIV/AIDS reside indeveloping countries and do not share this improvement in prognosis, (UNAIDS, 2009).
Studies conducted before the widespread use of ART showed that wasting wasassociated with diminished survival rate (Kotleret al., 1989).
Analysis of a morecontemporary cohort of patients, many of whom were taking highly activeantiretroviral therapy (HAART) showed that wasting still occurs and remains animportant predictor of death (Wankeet al., 2002).
Most of body composition studies have been done in developed countries and it wasfound out there were changes in body composition among HIV positive individuals onHAART or and those not on HAART (Ottet al., 1993; Yelmokaset al., 2001;Shikumaet al., 2004).
Although there are data available from developed countriesindicating that HAART may result in changes in body composition, these changesalong with dietary pattern of HIV positive individuals initiating HAART are lackingin resource limited settings (Schwenk, 1999; Wanke, 2002).
Good nutrition along with continued monitoring of body composition changes andantiretroviral treatment are therefore vital for the well being of PLHIV. Basing on this background this study therefore intends to investigate into the effect of antiretroviral drugs on nutritional status of adult aged 18-50 years, with specific reference to Bweyogerere health III.
