Six studies were reviewed to evaluate education on foodborne illness in people with HIV/AIDS: one before-and-after study, three cross-sectional studies and two narrative reviews.
People with HIV Infection are More Susceptible to Foodborne Illness
In a neutral-quality narrative review, Hayes et al (2003) reported that a compromised immune system causes people with HIV or AIDS to be more susceptible to foodborne illness from eating foods that are unsafely handled and poorly prepared and from using water from unsafe sources. Salmonellosis is estimated to be nearly 20 times more common and five times more often bacteremic in people with AIDS; the average incidence of salmonellosis in men 15 years to 60 years old with AIDS was 384 per 100,000, whereas the average annual incidence for men the same age was only 20 per 100,000.
Lack of Food Safety Awareness and Knowledge Among People with HIV Infection
In a neutral-quality cross-sectional study by Heathcock et al (1998), awareness of basic food hygiene and food safety was assessed in 77 HIV-positive individuals. There was some confusion and lack of knowledge about aspects of food storage. Despite the fact that 74% of subjects had modified their diet since learning their HIV status, only 25% reported receiving information about food safety.
In a neutral-quality, cross-sectional descriptive study by Hoffman et al (2005), a five-step model was implemented to assess the needs of people with HIV infection, develop educational materials targeted to their needs and evaluate acceptance of the materials. Sixty-five needs assessment focus group participants expressed resistance to and confusion about many recommendations. The preliminary survey showed that participants generally thought they were at higher risk than others for getting sick from unsafe food, recognized that foodborne illness could be a serious threat to their health and understood that handling or cooking food safely was important to staying healthy. The strongest motivators were a desire to know why certain foods should be avoided and prevention of foodborne illness.
Adherence of Home-Delivered Meals Programs to Food Safety Guidelines
In a neutral-quality, cross-sectional descriptive study by Balsam et al (1996), 15 of the 17 known home-delivered meals programs for individuals with HIV/AIDS in the United States were surveyed. Food safety and quality control were issues of great concern and addressed by all respondents; all programs committed to providing some orientation for their volunteers and employees to ensure appropriate concern for the person with HIV/AIDS and his/her family, food quality control and safe delivery of the meals.
In a neutral-quality narrative review [by Kraak (1995)] of 17 home-delivered meals programs for homebound people with HIV/AIDS, the adherence to food safety guidelines in the preparation and delivery of meals is of utmost importance. Meal programs need strict food-handling procedures, particularly when training volunteers to assist with meal preparation, and temperature studies are needed to ensure that the meals received are within acceptable ranges.
Effectiveness of Foodborne Illness Education for People with HIV Infection
In a negative-quality before-and-after study by Topping et al (1995), nutrition assessments and food safety education, as well as hot meals, snack packs and medical nutritional supplement sampler packs, were provided by dietitians to 47 people with HIV infection. Thirty-five participants received follow-up visits four weeks to eight weeks later. Dietitians reported that 13 of 35 participants gained weight (mean gain of 6 pounds), 11 participants maintained their weight and 11 participants lost weight (mean loss of 5 pounds). There was a decrease in the number of participants who reported symptoms and eating difficulties at the second visit (63%) compared with the first visit (77%).