Background: With Kenya classified as a UNAIDS fast track country, the HIV response is working towards achieving the global 90-90-90 targets. There remains a paucity of information on the impact of drought-related shocks on HIV response in arid and semi-arid lands which experience cyclical droughts leading to food insecurity and malnutrition both for the general population, but more so for PLHIV and TB clients. During crisis, limited data is available regarding the present status of nutrition as well as food security among PLHIV.
Assessment sought to establish the effects of drought on food consumption, food security and coping strategies among PLHIV and to explore the complex and interacting mechanisms that enhance or impede HIV response in ASAL areas in Kenya.
Methods: A mixed methods research approach was carried out in Kilifi, Kitui and Turkana counties using a composite score of drought severity, poverty index, HIV prevalence and malnutrition. 3 comprehensive care clinics (CCCs) were selected as the entry point. 1272 children aged 2 to 14 years, adult men and women were sampled.
Household Dietary Diversity Score was assessed using one 24-hour recall period. Food insecurity was assessed using the Household Food Insecurity Access Scale. Coping strategies to food insecurity were assessed using the Coping Strategy Index. Descriptive and multivariate analysis was conducted using SPSS v 24.
Results: Mean HDDS and dietary diversity score for Women were both 3.8, and below the minimum recommended threshold. 87% of female participants had low to medium dietary diversity. Prevalence of severe food insecurity was 69.4%. 78.5% of children 2-14 years were from severely food insecure households. 69.2% of adults reported low coping strategies to food insecurity. likelihood of being underweight increased with increasing food insecurity [OR 3.31 (95% CI 1.22-9.02); p=0.019] and low household dietary diversity [OR 2.64 (95% CI 1.48-4.72); p=0.01]. The odds of being underweight were higher in men, substance users, consumers of untreated water and those with high viral load.
Conclusions: PLHIV are exposed to many food security and coping shocks. Family food and livelihoods support in PLHIV households should be planned for and costed as part of HIV programming during drought in ASAL areas.

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