Feeding misperceptions around food and ART

  • Kim Johnson - 2 November 2012

An Ourhealth article featured on the Health-e website, which tells the storyof a woman who is putting off antiretroviral treatment (ART) because she does not have a steady supply of food, does not make it clear that while not ideal, antiretrovirals (ARVs) can be taken on an empty stomach or in the absence of a ‘good’ diet.

Making an honest attempt to shed light on a potential reason for why many people fail to start taking ART or do not take ART properly, the article gives Nombulelo Manala Lubhelu a platform to appeal for help and explain why she has made the decision not to start ART.

But while the story sheds light on one of the challenges facing many South Africans living with the virus, it also has the potential to perpetuate the incorrect belief that  ARVs must be taken with food, or that a healthy and balanced diet is a prerequisite for ART initiation.

The article largely focuses on Nombulelo’s appeals for assistance and investigates what is being done to improve her situation, but does not question the assumption at the heart of the issue—whether or not ARVs actually need to be taken with food.

Taking ARVs on an empty stomach can make the normal side effects of ART more intense, but is in no way harmful and does not make the ARVs any less effective.

It goes without saying that the extreme poverty and deeply entrenched inequality are crises in their own right. But a lack of food, or a lack of what is perceived as ‘good’ food, should not negate ART because without ART uncontrolled HIV infection will inevitably lead to death.

If taken correctly ART enables people living with HIV to live long and healthy lives akin to those of HIV-negative people.

And ART is not only important for those living with the virus; it has HIV prevention benefits too. Lessons from recent advances in what is now being termed ‘treatment as prevention’ have revealed that people on ART are less likely to transmit the virus to their sexual partners.

By not actively including a sort of disclaimer that sets the record straight on the fact that ART is just as effective when taken on an empty stomach or in conjunction with a less than adequate diet, this article risks perpetuating erroneous ideas around when and how ART should be taken.

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