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UBC Theses and Dissertations

A study of dietary and non-dietary factors of iron deficiency anemia in HIV-positive women Shahvarani, Dani Ladan


Anemia is one of the most common co-morbidities in human immunodeficiency virus (HIV), where approximately 50% of cases are attributed to iron deficiency anemia (IDA). IDA results from chronic inadequate iron supply to the body, whether through increased losses or decreased iron availability. In HIV, iron metabolism is greatly disrupted due to direct impacts of the virus, and therefore, prevalence of IDA is greater as compared to other populations. Women are at particularly high risk due to decreased dietary iron intakes, and increased losses due to menstruation and pregnancy. This study set out to determine the prevalence of anemia, iron deficiency and IDA, associated risk factors, and dietary iron intake patterns in a sample of HIV-positive women. Moreover, a newly-designed dietary survey was assessed for its ability to predict iron status in this population. It was found that the majority of participants had sub-optimal dietary iron intakes, with most dietary iron obtained from grain products. Prevalence of anemia, ID, and IDA were 30%, 40%, and 16%, respectively. Predictors for IDA in this sample were immune status (CD4<200 cells/µL); regular menstruation pattern; and African ethnicity. Food insecurity was quite prevalent among participants of Aboriginal and African ethnicity, with food bank use predominating as the main means of food assistance. Routine screening of iron status parameters, implementation of multivitamin use among all women with HIV, and dietary education regarding iron food sources is necessary to eliminate IDA in this population. Women with HIV should be engaged in self-management of their nutritional health, and community programs should be established that foster educational opportunities, rather than solely providing emergency food assistance.

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