Nutrition
HIV
With effective treatment the focus shifts from wasting to long-term cardiovascular and metabolic health — though food security remains the first issue for many.
What you are aiming for
- Maintain a healthy weight and muscle mass
- Support the immune system with an adequate, varied diet
- Manage the metabolic effects of some antiretrovirals: lipids, glucose, fat distribution
- Eat safely to reduce foodborne infection risk when CD4 is low
Build meals around
- Adequate protein daily: beans, eggs, fish, chicken, dairy, groundnuts, soya
- Whole grains and starchy staples for energy
- Vegetables and fruit, washed well, for micronutrients
- Iron and vitamin B rich foods, especially where anaemia is common
- Safe, treated or boiled drinking water
Limit or avoid
- Unpasteurised milk, raw eggs, undercooked meat and unwashed produce when immunity is low
- Alcohol, which affects adherence and the liver
- High saturated fat and sugary drinks, given the raised cardiovascular risk
- High-dose supplements taken without advice — some interact with antiretrovirals
Meal timing
- Follow the food instructions for your specific regimen — some need food, others an empty stomach.
- Tie medication to a daily meal to support adherence.
- Eat small frequent meals during periods of poor appetite or diarrhoea.
Portions
- Balanced plate: half vegetables, a quarter protein, a quarter starch.
- Increase portions during illness or weight loss rather than reducing them.
A sample day
- BreakfastPorridge with milk and groundnut paste; fruit
- LunchBeans with maize meal or rice and leafy greens
- SnackBoiled egg or yoghurt
- DinnerFish or chicken stew with vegetables and starch
Common myths
“Special foods or herbs can treat HIV.”
Nothing replaces antiretroviral therapy, and some herbal products reduce drug levels dangerously.
“Weight gain always means the treatment is working well.”
Some regimens cause significant weight gain and metabolic change. Track weight and lipids with your clinic.
Treatment-related challenges
- Diarrhoea and nausea in early treatment — small frequent meals, fluids with salt and sugar.
- Oral thrush and mouth pain — soft, cool, bland foods.
- Food insecurity — ask the clinic about food support programmes; adherence is harder when hungry.
- Tuberculosis co-infection substantially raises energy and protein needs.
See a registered dietitian if
- · Unintentional weight loss or wasting
- · Persistent diarrhoea
- · Raised lipids, glucose or significant weight gain on treatment
- · Pregnancy, or a child living with HIV
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.