Prevalence and Predictors of Undernutrition among Women of Reproductive Age Receiving Antiretroviral therapy (ART) at Yirgalem Hospital: Evidence from a Cross-Sectional Analysisal treatment (ART) programs

Abstract

Background: Human immunodeficiency virus (HIV) and malnutrition are interconnected in a vicious cycle, where each condition can independently cause progressive damage to the immune system. Recent, site-specific evidence on the prevalence and predictors of undernutrition among reproductive-age (15–49 years) women on ART at Yirgalem Hospital is lacking, as most Ethiopian studies focus on broader adult ART populations or other groups, leaving a gap for targeted, facility-level analysis. Assessing nutritional status in ART patients is vital, as it directly affects treatment effectiveness and outcomes, underscoring the need for integrated care. Method: A cross-sectional study was conducted with randomly sampled reproductive age women (15-49 yrs) on ART (n=268), to examine the prevalence of undernutrition and its correlates from February to May 2023. Data on socio-economic and demographic characteristics, nutrition-related factors, and health indicators—including CD4 count, WHO clinical stage, and opportunistic infections—were collected. Descriptive statistics such as frequency, percentage, mean, and standard deviation were calculated. Associations between socio-demographic and predictor variables were assessed using binary and multivariable logistic regression, with statistical significance set at p < 0.05 and 95% confidence intervals. Result: Nearly 39% of reproductive age women on ART were undernourished (BMI < 18.5 kg/m2). Women with no formal education (AOR=3.10(1.63, 7.60), advanced WHO Clinical stages (AOR=3.30(1.53, 7.11)), poor adherence to ART in past six months (AOR=3.43(1.78, 6.61), and food insecurity (AOR=2.10(1.25, 4.34) were significantly associated with undernutrition. Conclusion: Undernutrition remains a significant public health issue among reproductive-age women on ART. Key factors such as basic education for mothers, improving ART adherence, and addressing food insecurity are critical in tackling this problem. A longitudinal study is recommended to better understand these factors and develop evidence-based interventions aimed at improving the nutritional and health outcomes of women on ART.