HIV/AIDS Educate on Food and Water Safety

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

Recommendation(s)

HIV/AIDS: Educate on Food and Water Safety

The registered dietitian (RD) should educate people with HIV infection, especially those who are severely immunocompromised (having CD4 levels less than 200 cells per mm³) and others involved in their care, about food and water safety. Studies report that people with HIV infection are more susceptible to foodborne illness and also lack knowledge regarding food safety.

Rating: Strong
Imperative

Risks/Harms of Implementing This Recommendation

None.

Conditions of Application

None.

Potential Costs Associated with Application

• Costs of medical nutrition therapy (MNT) sessions and reimbursement vary, however MNT sessions are essential for improved outcomes
• Staff and volunteers, such as food providers, may also need to be trained on food and water safety.

Recommendation Narrative

• Six studies were evaluated regarding education about foodborne illness in people with HIV infection
• One narrative review concluded that people with HIV infection are more susceptible to foodborne illness (Hayes et al, 2003)
• Two studies reported confusion and lack of knowledge regarding food safety (Heathcock et al, 1998; Hoffman et al, 2005)
• Two studies evaluating home-delivered meals programs for people with HIV infection report strong adherence to food safety guidelines in the preparation and delivery of meals (Kraak et al, 1995; Balsam et al, 1996)
• One study evaluating a program that included a component of foodborne illness education demonstrated a decrease in the number of symptoms and eating difficulties in people with HIV infection (Topping et al, 1995).

Recommendation Strength Rationale

Conclusion statement received Grade I.

Minority Opinions

Consensus reached.

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Supporting Evidence

The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).

What is the evidence regarding education on foodborne illness for people with HIV infection and their caregivers?

References

Balsam A, Grant N, Rogers BL. Program characteristics of home-delivered meals programs for persons with HIV and AIDS. J Community Health. 1996; 21(1): 37-49.

Hayes C, Elliot E, Krales E, Downer G. Food and water safety for persons infected with human immunodeficiency virus. Clin Infect Dis. 2003; 36(Suppl 2): S106-S109.

Heathcock R, McLauchlin J, Newton LH, Soltanpoor N, Coker R, Bignardi G, McEvoy M Survey of food safety awareness among HIV-positive individuals. AIDS Care 1998; 10(2): 237-241.

Hoffman EW, Bergmann V, Shultz JA, Kendall P, Medeiros LC, Hillers VN. Application of a five-step message development model for food safety education materials targeting people with HIV/AIDS. J Am Diet Assoc 2005;105:1597-1604.

Kraak VI. Home-delivered meal programs for homebound people with HIV/AIDS. J Am Diet Assoc. 1995; 95(4): 476-481.

Topping CM, Humm DC, Fischer RB, Brayer KM. A community-based, interagency approach by dietitians to provide meals, medical nutrition therapy, and education to clients with HIV/AIDS. J Am Diet Assoc. 1995; 95: 683-686.

References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process

Hendricks KM, Dong KR, Gerrior JL, eds. Nutrition Management of HIV and AIDS. Chicago, Illinois: American Dietetic Association; 2009.

CDC Food and Water Safety Brochure, http://www.cdc.gov/hiv/resources/brochures/food.htm.