Nutrition and AIDS
The Increased Importance of Food...continued
To ensure adequate nutrition, people with AIDS are advised to eat five to six small meals per day instead of three large ones. If achieving needed levels of calories and nutrients is proving to be an obstacle, liquid supplements and vitamins can be taken. In severe cases of weight loss, enteral feeding might be prescribed.

In cases of HIV-Associated Wasting Syndrome, the underlying reason for the weight loss should be addressed where possible. Ulcers and infections which make swallowing and eating painful can often be treated with medications. For a loss of appetite, there are a number of appetite stimulants available. Megestrol acetate has been found to be particularly effective for HIV-Associated Wasting Syndrome. However, possible side-effects include: hypogonadism, adrenal suppression, deep vein thrombosis, and avascular necrosis. Dronabinol and cyproheptadine are also used as appetite stimulants in people with AIDS. For more information on appetite stimulants, please see the review by Mulligan and Schambelan.

In addition to ensuring proper nutrition, people with AIDS also must be particularly careful with food preparation. Because of their impaired immune systems, food poisoning can be especially devastating for people with AIDS. Bacteria found in many foods are handled without incident in people HIV-negative, but can pose problems for people with AIDS. Therefore, people with AIDS should avoid consuming raw meats and fish as found with sushi, sashimi, carpaccio, raw oysters, and ceviche. Unpasteurized milk products should also be avoided as should aged cheeses laden with bacteria such as blue cheese and Roquefort cheese. A good rule of thumb may be: if you can see the mold, do not eat it. Meat should be well-cooked and leftovers always treated with suspicion.

Food takes on an increased importance in the world of people with AIDS. However, obtaining adequate nutrition and making sure that food is properly prepared requires resources. All of the treatments for HIV-Associated Wasting Syndrome are expensive and unfortunately poverty is correlated to AIDS. AIDS can lead to discrimination and stigmatization by the community which translates into a loss of support, both emotional and financial. This social isolation, combined with deteriorating health, oftentimes leads to an inability to work. If finances were not an issue for a person before becoming HIV-positive, the circumstances accompanying the disease make it more likely that money will become an issue with the knowledge of being HIV-positive. With the lack of financial resources, treatment and health become compromised.