TRADE PROJECT

TITLE : PREVALENCE AND EFFECTS OF HIV/AIDS ON

NUTRITIONAL STATUS OF PEOPLE ATTENDING
THE COUNTY GENERAL HOSPITAL GARISSA

PRESENTED BY: ABDI FATAH BISHAR MOHAMED

INDEX NO :…………………………………………..

COURSE CODE: ……………..

PAPER NO . :…………………………………..

SUPERVISOR : MR. LAWRENCE

DECLARATION
I declare that this is my original work and has never been presented for the award of Diploma to
any Examining body.

STUDENT’S NAME : ………………………..

INDEX NUMBER : ……………………………

SIGNATURE : ……………………………

DATE : ……………………………
 CHAPTER ONE
1.1 BACKGROUND OF THE STUDY
HIV/AIDS is the most devastating diseases human kind has ever had the beginning of the
pandemic; more than 60 million people have been infected with HIV.
Pathogenesis and treatment is a unique opportunity for leading scientists, public health experts
and clinicians to examine the latest scientific development related to HIV and explore how such
advances can inform the global responses to the epidemic.
HIV stands for Human Immunodeficiency Virus. The virus enters cells that are responsible for
defending the body against pathogens and illnesses. The virus destroys the Immune system of the
body.

HIV is an RNA virus that was discovered in 1983. RNA virus are also known as retroviruses.
HIV is an obligate parasite, it cannot survive and replicate unless it is inside a living cell.
HIV can enter a cell by binding to a specific CD4 receptor sites on the cells surface once the
virus RNA enters a cell, it is transcribed into a single strand of viral DNA with the assistance of
an enzyme called reverse transcriptase. These strands then replicate and become double strand
viral DNA .At this point the viral DNA can split itself into genetic material in the nucleolus of
the host cell becoming a permanent part . Materials are replicated during cellular division, all of
these daughter cells will also be infected, and since the genetic code can direct the cell to make
more HIV.
AIDS occurs when the immune system is weakened by the HIV Virus to a point whereby a
person becomes susceptible to opportunistic infections such as cancers, TB which lower the
immunity completely.

HIV wasting syndrome is an AIDS defining condition. There is involuntary weight loss of greater than 10%
of total body weight and either chronic diarrhoea or general body weaknesses also documented fever longer
than 30 days in the absence of concurrent illness
infections symptoms such as nausea, vomiting, diarrhoea, dysenea, or fatigue or neurological
diseases can be witnessed.
Globally, approximately above half of all people living with HIV are female. In high prevalence
countries, girls child enrolment to schools has decreased in the past decade. Girls are often taken
out of schools to look after the sick relatives or their young siblings.
1.2 STATEMENT OF THE PROBLEM.

Seventy percent of all new HIV infections take place in Africa (UNAIDS, 2003) and there is no
doubt that HIV/AIDS is no-longer a health challenge. The impact of HIV/AIDS is pervasive and
far reaching affecting individual aids communities not only psychological but also socially.
Families lose their most productive members to this disease, leaving children and the elderly
people without means of support. The high cost of the disease wrecks havoc within the
communities where the already fragile structures are not capable of absorbing further strain.

By now starting statistics are driving home the reality of this disease and most of the countries
affected have often with significant delay put in place programs and activities aimed at
combating the spread of HIV/AIDS. They include mass media campaigns, improved health
facilities for early detection and treatment of sexually transmitted infections that facilitate other
opportunistic diseases, voluntary HIV testing, peer education counseling and awareness activities
within hospitals and other institutions, community level awareness building.

1.3 PURPOSE OF THE STUDY

The study seeks to understand and identify the people living with HIV/AIDS and find ways of
improving their living standards and also their nutritional status.

1.4 RESEARCH QUESTIONS

(i) What are the factors affecting people living with HIV/AIDS?
(ii) What are the socio-demographic factors affecting nutritional status of PLWHA?
(iii) What is the prevalence of malnutrition among PLWHA?
1.5 GENERAL OBJECTIVES
To establish the prevalence and effects of HIV/AIDS on the nutritional status of people living
with HIV/AIDS.

1.5.1 SPECIFIC OBJECTIVES

(a) To assess the dietary intake of people living with HIV.
(b) To identity factors affecting people living with HIV.
(c) To determine socio-demographic characteristics affecting nutritional status among PLWHA.
(d) To determine the prevalence of malnutrition among PLWHA.
1.6 HYPOTHESIS
HI: This is a significant relationship between the prevalence of HIV/AIDS and poverty.
HO: There is no relationship between HIV prevalence and poverty.

1.7 JUSTIFICATION
The finding of the research sheds light on the challenges which people living with HIV in
provincial general hospital Nakuru face and factors that affect their nutritional status. The
information will assist the government through the ministry of public health and sanitation
formulate programs and policies to improve the lives of people living with HIV.
This study also have seeks to find ways of ensuring that people living with HIV have access to
adequate medication, nutrient supplements and adequate information through counseling. This
will be achieved through the partnership of Government and Non-governmental organizations to
provide intervention programs.

1.8 LIMITATIONS OF THE STUDY

(a) The research was restricted on HIV/AIDS only.
(b) Unfavorable weather condition since it was during rainy season.
(c) The research was limited to one specific area that is Provincial General Hospital Nakuru.
(d) Language barriers.
 CHAPTER TWO
2.0 LITERATURE REVIEW
In 1979 a new disease, Acquired Immunodeficiency Syndrome (AIDS) appeared within a decade
this disease would reach epidemic proportions, dominating health news, taxing health care
delivery systems, forcing a redirection of medical research and most importantly adversely
affecting the lives of millions. T he AIDS epidemic is the ‘Plague’ that threatens modern society
(Ronald m, 1995).
According to Lucy Bardey-springer, HIV had infected people in Africa as early as 1959 where it
was called ‘slim’ disease because of the severe weight loss that accompanied advancing illness.
The disease was contained in small areas in Africa for several decades until urbanization,
changing work habits and improved transportation brought infected people into contact with
others.HIV and associated epidemic of tuberculosis continue to spread rapidly.
WHO project revealed that, by the year 2000, up to 40 million people will be infected.
HIV wasting syndrome is an AIDS defining condition. There is involuntary weight plus either
chronic diarrhoea or weakness and documented fever, longer than 30 days is the absence of a
concurrent (CDC 1992).
Weight loss and wasting are multifactoral, related to lack of adequate intake, malabsorption,
metabolic irregularities, uncontrolled opportunistic infections or lack of physical activity.
Decreased oral intake can result from anorexia secondary to medication, depression, infection
symptoms such as nausea, vomiting diarrhea, dyspned or fatigue or neurological diseases
(mangili et al, 2006)
Problems leading to malnutrition may involve ingestion, absorption, digestion, metabolism and
use of nutrients without successful ART, protein-energy malnutrition (PEM) is a frequent
complication of advance HIV disease (Moligan et al, 2001)

2.1 CHARACTERISTICS OF HIV

AIDS is caused by retrovirus named HIV (Human Immunodeficiency Virus), A retrovirus is an
RNA virus that uses viral reverse transcriptase to make DNA and then that DNA for making new
viruses. The viruses are composed of a central core that contains two identical single strand of
several core proteins. The core is surrounded by a matrix protein that in turn is surrounded by a
lipid envelope (Ronald. 1995)
The ability of HIV to infect depend adoption to specific receptors. HIV preferentially binds to
CD4 receptors and infects cells. The receptors is used by the TH cells to recognize antigens in
association with the major histocompatibility complex, (mulligan et al 2001)
HIV can enter a cell by binding to specific CD4 receptors sites on the cells surface. Although
HIV can infect several types of human cells, Immune disfunction results predominantly from the
destruction of helper T lymphocytes. These lymphocytes are targeted because they have more
CD4 receptors sites on their surface than other cells.
Human normally have 800-1200 helper T lymphocytes/mm3 of blood (Lucy Bradley 1992)

2.2 BODY RESPONSE TO HIV INFECTIONS

HIV replication leads to a decline in the TH cells since the TH cells is often at the centre of
activating T and B lymphocyte response, functional changes in both kinds of lymphocytes are
seen (Sandra S.G 1994). General one infection follows another in people infected until death
occurs.
The over all effects of HIV infection is a depressed immune response individuals with AIDS
exhibit immune suppression as a result they subjected to infections by numerous opportunistic
pathogens and to development of several forms of cancer.

2.3 TRANSMISSION OF HIV

The AIDS causing human immunodeficiency virus is transmissible primary by sexual contact
both by homosexual and heterosexual, contaminated body fluids including semen and blood
carrying the virus. In addition to sexual transmission the virus can be spread across the placenta
of an infected mother to foetus (Ronald M.A, 1995)
Although the virus is found in saliva of infected individuals,t here is no evidence of transmission
by even prolonged casual contact. Blood sucking insects such as mosquitos have not been found
to be vectors in transmission of HIV (Sandra S.G 1994)

According to WWW.aidsinfo.nih.gov, transmission of HIV infection occurs by:

1. Sexual contact with infected person sexual activities provides an opportunity for
contact with semen, virginal secretions and or blood.
 2. Parental transmission i.e by
- Intravenous drugs abusers by sharing syringes.
- Recipients of blood and blood products have received multiple transfusion of all
blood.
3. Parental transmission from mother to a child during pregnancy, transplacentary or
immediate post-partum period through contamination with maternal blood, infected
amniotic fluid or breast milk.

2.4 DIAGNOSIS OF AIDS

Frequent used assays for HIV are ELISAS that detect the presence in the serum of the viral care
or antigen, p24 to the HIV. The individuals that have reactive serum after repeated tests are
confirmed to be HIV positive. Further confirmation of diagnosis may be made using direct
immune fluorescence assay,(IFA) to detect virus or western immune blot assay to detect HIV
specific antibodies in tissues and fluids. The most sensitive method to detect HIV is a
polymerase chain reaction (PCR) assay (Ronald M. A, 1995)
Blood test is the most common way to diagnose HIV. Early testing helps develop a treatment
plan to help fight HIV and ward off complications. It also helps avoid high risk behaviours that
could spread the virus to others (Wikipedia.org/Aids)

2.5 SIGNS AND SYMPTOMS OF AIDS

Some common symptoms include:
• Diarrhea that lasts more than one week.
• Dry cough
• Memory loss, depression and neurological disorder
• Pneumonia
• Profound unexplained fatigue
• Rapid weight loss
• Recurring fever or profuse night sweats
• Swollen lymph glands in the armpits, groin or neck.
• White spots of unusual blemishes on the tongue, in the mouth or in the throat.
 • Since AIDS weakens immune system, individuals who are affected are prone to
opportunistic infections
• Vision loss.
• Shortness of breath
(Gallo R.C Montagnier 1987)

2.6 OPPORTUNISTIC INFECTIONS AND COMPLICATIONS

2.6.1 CANCERS
Kaposis sarcoma, non hodkins lymphomas, and cervical cancers are AIDS defining for someone
with HIV (Bartlet 2006)

2.6.2 TUBERCULOSIS AND LUNG DISEASE

HIV and TBco-infections may cause immune activation and rapid increase in the rate of HIV
replication (sterling ET al s 2001)

2.6.3 GASTROINTESTINAL AND PANCREATIC TISSUES

M. aviam complex greatly decrease in incidence since the use of powerful HIV medications can
be seen in the lymph nodes, liver, bone narrow, blood and urine of patients with AIDS. Chronic
diarrhea may persist in the absence of identifiable neteric pathogens as a result of what is known
as AIDS enteropathy: (saagam 2002)

2.7 MEDICAL NUTRITION THERAPY

Nutrients deficiencies play important role in the pathogenesis of HIV disease. The goals of
intervention are:
• Maintain and expand nutritional knowledge and sence of empowerment.
• Maintain healthy body weight and normal morphology.
• Pressure or restore optimal somatic and visceral protein status.
• Prevent nutrient deficiencies or exercises that can compromise immune functions
• Treat or minimize HIV or medication-related complications that interfere with either
intake or absorption of nutrients
• Correct metabolic abnormalities.
 (woods M.N et al 2002)

A comprehensive nutrition assessment should be performed. The diet should be evaluated for
nutrient adequacy, especially for nutrients involved with the immune function. Monitoring
changes in anthropometric measurements over time is feasible. Useful measurements include
waist, hip and neck circumference, lean body mass or body cell mass (mangili A et al, 2006).
It is important to educate individuals on the importance of consuming a well balanced diet to
provide adequate nutrients for maintenance or improvement of nutritional states, to prevent
protein energy malnutrition and vitamin, mineral deficiencies. (Grufeld and Feingold, 1992).

2.8 RELATIONSHIP BETWEEN HIV/AIDS AND MALNUTRITION

Problems leading to malnutrition my involve ingestion, absorption, digestion, metabolism and
utilization of nutrients without successful ART, protein – energy malnutrition (PEM) is a
frequent complication of advanced HIV disease (Miligan et al 2001)

2.9 NUTRITION MANAGEMENT

i) Importance of early intervention.
ii) Adequate intake of fluids and nutrients.
iii) Importance of food and water safety and sanitation.
iv) Regular exercise and physical activity.
v) Psychosocial economic factors of food.
vi) Additional food resources to meet needs.
vii) Dietary multiple vitamins and mineral supplements.
viii) Monitor/manage metabolic abnormalities.
ix) Small frequent nutrients dense meals.
x) Appetite stimulants.
xi) Peripheral or total peripheral nutrition.
xii) Anabolic therapies.
2.10 PREVENTION OF HIV/AIDS
There is still no evidence that there is a cure or vaccine which will be developed soon. The only
absolude defence against HIV is prevention through education on risky behaviours and risk
reduction (www.gov/search 2007)
Elimination of risks related to sexual activities include:- abstinence or environment in mutually
monogamous relationships where neither the partner is infected risk reduction includes correct
and consistent use of condoms, decreasing number of sex partners (Lucy 1990)

2.11 PREVALENCE OF HIV

Prevalence is the number of people living with HIV infection at a given time. Such as at the end
of a given year.
At the end of 2009, an estimated 1,148,200 people aged 13 and older were living with HIV
infection in the United States, including 207,600 (18.1%) persons whose infections had not been
diagnosed (CDC) 1011.

2.12 CONCLUSION
HIV infection will continue to be a wildwide epidemic for the foreseeable future, brining with it
untold suffering and early death.
Education and prevention are the only known ways to decrease the devastation caused by HIV,
but these efforts are always hampered by social, cultural and governmental policies that restrict
the presentation of information
about risk reduction measures.
 CHAPTER THREE
3.0 METHODOLOGY
3.1 STUDY AREA
Provincial General Hospital Nakuru is situated in Nakuru town, Nakuru County. At National
level it is the 4th largest town in Kenya after Nairobi, Mombasa and Kisumu respectively. It has
an area of 290 Kms2 and located North West of Nairobi at the Great Rift Valley. It has an
altitude of 1859 meters above sea level.

Nakuru serves as provincial and district headquarters. It also acts as administrative, industrial,
commercial and service centre for the sorrounding agricultural lands. It serves as the main town
in the county.
Nakuru has an estimated population of 500,000 people. Nakuru PGH is a hospital which serves
people from all over the country. Number of hospitals in Nakuru county is 15. Number of other
health facilities 279. The average distance to the nearest centre 8 Kms.

3.2 TARGET POPULATION

Nakuru County has a population of about 500,000 people. Most of these people live under
/below the poverty line and the causes of poverty include: under utilization of available
resources, inadequate distribution of resources, high costs of farm inputs, lack of market for farm
produce, poor and inadequate education, unemployment, poor business skills and inaccessibility
to credit facilities. A family’s socio-economic status is based on family income, parents’
education level, parental occupation and social status in the community.
The residence are farmers and entrepreneurs. They major in crops like maize and other vegetable
garden crops. There is a ready market situation in town, where farmers can sell their produce.
Transportation system is fair compared to other parts of the country.

3.3 SELECTION OF STUDY SAMPLE

To ensure that the researcher got data that would represent the whole population, the researcher
used a random sampling. This method is most convenient in populations that vary in age,
sex/gender etc. The advantage of this method is that it ensures inclusion in the sample of sub
groups otherwise would be emmited entirely by other sampling methods.
3.4 SAMPLING SIZE
The study subject was 140 respondents i.e 80 female and 60 male. This gave the researcher
relevant information that would be used to answer the questionnaires appropriately, and to know
how malnutrition among people living with HIV/AIDS has prevailed.

3.5 DATA COLLECTION TOOLS

Data was collected by use of questionnaires, individuals were selected from active participants
and who were willing to fill the questionnaires. The study was based on cross-sectional data
obtained at baseline. The study collected anthropometric measurements, medical history,
lifestyle factors and data was calibrated.

3.5.1 STRUCTURED QUESTIONNAIRES

The questionnaire contained both structured and semi-structured questions. This allowed the
respondents to give their opinions where necessary, since a questionnaire is a standard research
instrument, it allows for uniformity in the manner in which questions are asked. The
questionnaire included sections on: socio-economic factors, demographic information, cultural
factors, psychological factors, dietary assessment and anthropometric measurements.

3.5.2 INTERVIEW SCHEDULE

Interview schedule was used to collect information on the nutritional status and also establish
morbidity patterns and daily dietary intake. The reason for use of interview is that the researcher
can get opinion of the respondent.

3.5.3 FOCUS GROUP DISCUSSION

A focus group discussion was held to discuss factors affecting people living with HIV/AIDS. 30
people participated. There was an open forum where the participants gathered together to share
their problems. This discussion had facilitators who ensured that the discussion met the
objectives.
3.5.4 ANTHROPOMETRY
Tools used during the study included: height board for height scale for weight, mid upper arm
circumference tape for muscle wasting, body mass index charts for detecting the body mass
index of an individual.
 CHAPTER FOUR
4.0 DATA PRESENTATION, ANALYSIS AND INTERPRETATION
4.1 INTRODUCTION
This chapter contains the results that the researcher came up with from Provincial General
Hospital Nakuru. It shows how the data was presented and analyzed as well as reporting of the
findings and responses. The researcher used tables, bar graphs and pie charts.

Table 4.1: Gender of Respondents

SEX NUMBER PERCENTAGE
Female 80 57.1
Male 60 42.9
Total 140 109

Figure 4.1: A pie chart showing gender Respondents

43.00%
Female
Male

57.00%

With the aid of the table a pie chart above, it is evident that female make up 57.1% and male
42.9%
Female are mostly affected than male.
Table 4.2: Ages of Respondents
AGE NUMBER PERCENTAGE
Below 1 10 71
1 – 20 35 25
21 – 30 60 42.0
31 – 40 20 14.3
Above 40 15 10.7
Total 140 100

Figure 4.2: A bar graph showing the ages of Respondents

45.00%

40.00%

35.00%

30.00%
P
e
r 25.00%
c
e
n
20.00%
t
a
g
e 15.00%

10.00%

5.00%

0.00%
Below I year 1 - 20 years 21 - 30 years 31 - 40 years Above 40 years
Ages

From the bar graph and the table above, it shows that the age below 1 year is 71%, 1 – 20 years
is 25%, 21 – 30 is 42.9%, 31 – 40 is 43% and above 40 years is 10.7%. From this data it shows
that people of ages 21 – 30 years are the most affected.

Table 43: Marital status of Respondents

STATUS FREQUENCY PERCENTAGE
 Single 40 28.6
Married 60 42.9
Divorced 20 14.3
Widowed 20 14.3

Figure 4.3: A bar graph showing marital status

45%

40%

35%

30%
P
e
r 25%
c
e
n
t 20%
a
g
e
15%

10%

5%

0%
Single Married Divorced Widowed
Status

From the table and the graph above, it shows that 28.6% are single, 42.9% are married, 14.3%
are divorced and 14.3% are widowed. The analysis shows that the highest percentage i.e 42.9%
are married.

Table 4.4: Source of Income of the Respondents

Type of Job Frequency Percentage
Farming 50 35.7
Self employed 45 32.1
Employed 25 17.9

Others 20 14.3

Figure 4.4 : Pie chart showing sources of Income

Sales

14.00%

36.00%
Others
Employed
18.00% Self Employed
Farming

32.00%

With the aid of the table and the pie chart it shows that those doing farming are 37.5%, self
employed are 32.1%, employed are 17.9% and those taking other jobs are 14.3%.
Table 4.5: Diagnostic Period.
First diagnosis Frequency Percentage
Less than a month 10 7.1
1 – 4 months 30 21.4
5 – 10 months 40 28.6
Over 10 months 50 35.7
Figure 4.5: A bar graph showing diagnostic period
 30%

25%

P 20%
e
r
c
e
n 15%
t
a
g
e
10%

5%

0%
Less than a month 1 - 4 months 5 - 10 months Over 10 months
Diagnostic period
Table 4.6: Attendance of Respondents to health facilities
FREQUENCY PERCENTAGE
NO 40 28.6
YES 100 71.4
TOTAL 140 100

Figure 46: A pie chart showing the attendance of Respondents to health facilities

29.00%

No
Yes

71.00%

From the above representation it shows that 28.6% do not attend health facilities and 71.4% i.e
the majority, attend health facilities for medical check-ups.
Table 4.7: Number of meals consumed per day
Number of meals Frequency Percentage
More than 3 50 35.7
3 60 42.9
2 20 14.3
1 10 7.1

Figure 4.7: A bar graph showing the number of meals consumed in a day.

45%

40%

35%

30%
P
e
r
c 25%
e
n
t
a
g 20%
e

15%

10%

5%

0%
One Two Three More than three

Meals per day

 From the data above it shows that 35.7% of people consume more that 3 meals per day, 42.9%
consume 3 meals per day, 14.3% two meals and 7.1% consume 1 meal per day. The most people
consume 3 meals a day.

Table 4.8: Type of food Taken

Type of food Frequency Percentage
Locally available 90 71.4
Commercial 40 28.6
Total 130 100

Figure 4.8: Type of food taken (pie chart)

29.00%

Locally Available
Commercial food

71.00%

From the data above it is clear that 71.4% consume locally available food and 28.6% consume
commercially prepared food.
Table 4.9: Frequency of Physical Activity
Active Frequency Percentage
Yes 70 50
No 70 50
Total 140 100

Figure 4.9: A pie chart showing frequency of physical activities

Yes
No
50.00% 50.00%

From the data it is clear that 50% participate in physical activities and 50% do not participate in
physical activities.
CHAPTER FIVE
5.1 SOCIAL-DEMOGRAPHIC FACTORS
The major findings was that the most affected gender is the female, this is because most of them
are raped, culture that dictates that women must be submissive thereby limiting their sexual
power to negotiate for safer sex, believes i.e believing that engaging in sexual intercourse with a
virgin is a cure for Aids, also biologically female have a large surface area at the vagina that is
made up of soft tissues which makes it easier for viruses to penetrate.
It is evident that female mature faster than male therefore they tend to engage in sexual
intercourse while still young and at this stage their reproductive organs are fragile which make
penetration of the viruses easier.
It is also clear that culturally men are polygamous and this means that women will be vulnerable
to HIV infections.
Poverty is also a major case since women will be looking for rich family men to acquire money
from them, which disposes them to easy acquiring of viruses.

5.2 PREVALENCE
The most commonly affected age group is between 21-30 years, this is because at this age it’s
the most sexually active age in life.
Individuals with less income are mostly affected most residents are farmers and their income is
not sufficient thus forcing them to look for alternative ways of getting money for example
engaging in sexual activities.
Families live in large numbers and this leads to poverty. Therefore parents are not capable of
affectively providing for their children causing them to live wreckless lifestyles.

5.3 TYPE OF FOOD

Families consume meals three times a day, this is due to majority are low income earners, people
especially living with HIV/AIDS are not able to get enough food to boost their immune systems
and meet their daily needs.

CHAPTER SIX
6.1 CONCLUSION AND RECOMMENDATION
From the collection of data, the research found that the cause of increase in HIV/AIDS cases in
the area is mainly influenced by low income earning. Most people are farmers and do not get
enough to feed their families. Also some residents are not well educated especially in maters
pertaining culture.
From this research it has been found that there is a relationship between low income earning and
the high rise of HIV/AIDS in Nakuru District.

6.2 RECOMMENDATIONS
In order to reduce the risk factors of the spread of H IV/AIDS, the research recommended the
following:
(i) Education on HIV/AIDS
Most people are not well informed about HIV/AIDS. The government should find ways of
reaching people in their local homes, schools, institutions and even hospitals to give detailed
information concerning HIV/AIDS. This can be done by help PLHIV to adjust and learn more
about lifestyle changes that will help reduce risk of HIV infections and also help cope with HIV
positive status and live a meaningful life.
Formation of groups helps PLHIV to avoid stigma as they will not be isolated and this will
enable them to socialize effectively and get required support.

(ii) Employment
The government should create more job opportunities for the educated with no jobs and also
those who did not get opportunities to go to school. This will help eradicate poverty and improve
living lifestyle. It also helps to avoid idleness and therefore reduce chances of immorality.

(iii) Nutrition Education

Nutrition Education is very important in the lives of PLHIV. Most of HIV patients are not aware
of the importance of proper nutrition. Good Nutrition help PLHIV to reduce nutrition related
complications and also helps to strengthen their immune system. This can be achieved by
conducting forums whereby a nutrition counselor advices them on the importance of proper
nutrition during the forums too, food supplements can be distributed to encourage them to eat
well.
QUESTONNAIRE
I am a student at the Eldoret polytechnic taking a diploma course in dietetic management. I am
carrying out a research on prevalence and effects of HIV/AIDS a case study carried out in
provincial General Hospital Nakuru. Nakuru county.
You are hereby kindly requested to help with the needed information by responding to the
following questions and strictly be for academic research.
The research will contain the following sections, demographic information, family size, disease
prevalence and dietary asssessment.

APPENDIX 1: QUESTIONNAIRE.
SECTION A: DEMOGRAPHIC INFORMATION.
A. Name
Sex (i) Male

(ii) Height
(ii) Fem ale

B. Age (i) Below 1

(ii) 1-20

(ii) 21-30

(iv)31-40

(v)Above 40
D. Anthropometric measurements
(i) Weight
 (iii)MUAC

(iv)BMI

E. What is your marital status?

(i) Single

(ii) Married

(iii) Divorced

(iv) Widowed

F. What is your main source of income?

(i) Farming

(ii) Self employed

(iii) Employed

(iv) Others
G. What is your monthly income?
(i) Less than 1,000

(ii) 2,000-10,000

(iii) 11,000-20,000
(iv) Above 21,000
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