Background: Kenya is one of the UNAIDS fast track countries and global plan PMTCT countries. High levels of malnutrition and food insecurity exist in the arid and semi-arid areas in turn affecting PLHIV and their households. In 2017, Kenya experienced a serious drought leaving 3.1 million people food insecure. However, there was no clear data on the impact of the drought on PLHIV and the country''s HIV response. Nutrition and food security status of PLHIV accessing treatment was assessed to guide decision making on appropriate nutrition and food support interventions for comprehensive treatment packages.
Methods: Descriptive cross-sectional national survey that sampled 3690 respondents, (2790 adults and 900 children) from 31 Comprehensive Care Clinics (CCCs) in 10 national AIDS and STI Control Programmed (NASCOP) operating regions. Target population were clients aged from 6 months onwards enrolled at CCCs. Three categories of clients considered; clients on prophylaxis not on ART; on ART < six months and on ART > six months. SPSS v.18 and WHO Anthro softwares were used.
Results: Thinness was more prevalent in males: Pre- ART 26.1%, Early ART 22.5% and Late ART (22.0 percent) than in the females (12.6 %) among Pre- ART, (14.9%) among Early ART and (13.7 %) among Late ART. Overweight/obesity was (23 %, 15.7 % and 20.4 %) in Pre- ART, Early and Late ART respectively. Late ART females presented with the highest prevalence of overweight/obesity 28.0 % and Early ART male clients had the lowest prevalence (5.8 percent). More boys (53.3%)than girls 36.9% were stunted among children 24-59 months(p=0.04). Severe thinness was higher in boys (14.3 %) compared to girls (11.3 % (P=0.773).
In adults, Food Consumption Score(FCS) was acceptable (>35). (88 %, 85 %, and 83 %) of Early ART, Pre- ART and Late ART respectively, had acceptable FCS (FCS>35). 10 to 13 %had borderline FCS (21.5-35), while 5 % had poor FCS (0-21).
Conclusions: Men and women are presenting different forms of malnutrition. Underweight in children and men, and overweight in females depicts the challenge of managing the double burden of malnutrition in PLHIV and calls for interventions that take into cognizance the emerging trend.

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