Improvement in the global prevalence of HIV infection suggests the world has seized an upper hand in the war on HIV and AIDS.
Worldwide there were 2.7 million new cases of HIV infection in 2010, according to UNAIDS. That’s down from 3.2 million a decade earlier. In Massachusetts new infections have decreased by 54 percent since 1999.
But declaring victory is premature. Infection rates for Americans between the ages of 13 and 30 are actually increasing. Overall — despite the 10-year downward trend globally and in Massachusetts — 56,000 Americans become infected with HIV each year, according to the Centers for Disease Control and Prevention. More than 14,000 Americans with AIDS die each year.
A quarter century of medical science has given us important tools: antiretroviral drugs have helped wrestle HIV from a routinely terminal diagnosis to a chronic, treatable condition. The transmission rate from mother to child has been virtually eliminated. The approval of the preventive drug Truvada by the FDA offers the latest signs of hope and promise for further curbing the trend of infection.
One weapon that is just important today as it was at the advent of this epidemic: diet and nutrition.
Food is medicine in so many ways and with regard to so many medical conditions. For patients living with HIV and AIDS, it quite literally can mean the difference between tolerating medications and maximizing their benefit or suffering debilitating symptoms and a more rapid progression of infection.
Medically tailored meals for HIV patients strengthen the immune system and enable the body to better fight the disease. Dramatic weight loss and “wasting syndrome” are some of the most common problems associated with HIV and AIDS — even for those who are treated properly with antiretrovirals. But good nutrition acts as a positive catalyst — helping the body process medications used in HIV treatment. A robust and appropriate diet also helps control symptoms such as diarrhea, nausea and fatigue, and it evens out the metabolic impacts patients often experience such as high blood sugar and elevated levels of cholesterol.
The experiences of HIV patients have been instructive to other disease management. The similarities between the relationship of diet and nutrition to the most effective treatment of cancer patients are striking.
And where there are specific choices that can impact the risk factors for those vulnerable to HIV, so too can the pandemic course of diabetes be altered by diet and nutrition.
As is the case with other conditions, managing HIV and achieving a good quality of life requires an individual commitment from patients. A recent study by the British Columbia Centre for Excellence in HIV/AIDS found that rigid adherence to highly active antiretroviral therapy (HAART) significantly lowered mortality rates as compared to those who followed less stringent drug regimens. Further, researchers in a large, two-year study in San Francisco found that severely food-insecure people with HIV/AIDS were more than twice as likely to be hospitalized compared to those who were food secure.
Every useful tool must be deployed against HIV if we have any hope of declaring a real victory for future generations. We are slowing the progress of disease in those who are infected, and providing new options for reducing risk of infection in otherwise high risk populations.
But a real focus must be placed on understanding the role that nutrition plays in maximizing the effectiveness of medical science, and providing access to medically tailored meals for the food insecure.