Interactions between HIV, dietary diversity and socioeconomic position in an urban African setting

Design and objectives: Across-sectional field study was undertaken to assess the impact of HIV on dietary diversity in an urban context. Setting and subjects: The study interviewed the food preparers of 47 households in Misisi Compound, a poor area of Lusaka, Zambia. Participants were stratified by the sex and HIV status of the nominal household head. Outcome measures: Outcome measures were difference in mean Household Dietary Diversity Score (HDDS, 12 food groups), and achievement of HDDS target for assessing food security. Results: The HIV status of the household head was associated with socio-economic position in femaleheaded households, with HIV-positive individuals significantly more likely to head a household of higher socio-economic position (P=0.037). HIV status was not associated with dietary diversity or any other measure in the study. Conclusions: This study found no association between HIV infection in the household head and access to a diverse diet. This may be because while wealthier households are disproportionately affected by HIV in this population, they are also better placed to cope with the pressures of the diseaseand maintain food security. Coping strategies employed to maintain food security in urban populations should be further investigated.