Matthew Burkey

Framework Program in Global Health: Grant Recipients

Matthew Burkey
The Effects of Food Aid on HIV-Infected Patients in Kampala, Uganda
Fall 2006

JHU advisor: Steven Reynolds
Country: Uganda
Program: School of Medicine, MD/MPH program

Matthew Burkey Project Abstract:
CONTEXT: Food insecurity and malnutrition are widely recognized as major contributors to morbidity and mortality in sub-Saharan Africa. While little data exists, food insecurity is hypothesized to be a major co-factor in the HIV epidemic through its contributions to vulnerability to risky sexual behavior, decreased tolerance of antiretroviral medications, and poor compliance secondary to competing priorities. To date, there have been few systematic investigations of the benefits of food aid in the setting of ART programs.

OBJECTIVE: To assess the impact of food aid on clinical and laboratory outcomes in HIV/AIDS patients. A secondary objective is to assess the impact of food aid on livelihood security levels.

DESIGN: A cross-sectional evaluation of HIV-infected patients enrolled in a food aid program between January 1, 2005 and March 1, 2006. Duration of follow-up is at least one year. Clinical, adherence, and immunologic outcomes will be assessed. Outcomes will be measured and compared for those receiving food aid compared with control groups who were not eligible for food aid.

SETTING: The current study is set in Reach Out Mbuya Parish HIV/AIDS Initiative (RO), a community- and faith-based organization operated by the Our Lady of Africa Church in Mbuya, Kampala, Uganda. The mission of RO is “to provide free medical care, social, spiritual, and emotional support for those living with HIV/AIDS in Mbuya Parish, with a special focus on those for whom such services are out of reach.” The initiative operates a number of component programs as a part of its holistic care model, including food aid, adult literacy programs, and a microfinance program. One of the components is a medical clinic, which offers consultations, home visits, health education, and laboratory services. The clinic is primarily nurse-driven, with a physician available on-site at all times for consultation. The clinic began providing ART in 2003 with primary funding through grants from the Centers for Disease Control and Prevention. In 2003, RO began offering food aid to HIV-infected clients through the World Food Program.

PATIENTS: HIV-infected patients from RO will be included in the analysis who directly received ART through RO and were evaluated for the food aid program between January 1, 2005 and March 1, 2006. Sixty-seven percent of RO’s clients are women. All the patients reside in Mbuya Parish, one of the poorest areas in Kampala.

MAIN OUTCOME MEASURES: The primary outcome of our study is change in CD4 count. Secondary outcomes include change in BMI, change in livelihood security level, and mortality.

CURRENT STATUS OF PROJECT: Currently, the investigator is abstracting data from clinical forms and preparing for the data analysis phase. Project completion is expected in May.

>> See all Fall 2006 Framework Award winners