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Coping with the complications of HIV/AIDS

Suggestions are made in this chapter as to which foods should be eaten or avoided for the following symptoms:

A person may have two or more of these conditions at the same time so will need to choose suitable foods carefully. Since people react to foods differently, they will have to select those that work for them. Normal mixed diets can be resumed as soon as the problem is resolved.


When a person passes a watery stool three or more times a day, they have diarrhoea. Diarrhoea is a problem for many people with HIV/AIDS; it leads to loss of water and minerals from the body. This loss is even greater if the person is vomiting. In severe cases, diarrhoea causes dehydration, poor absorption of food, significant weight loss and malnutrition, resulting in weakness and further illness. In young children diarrhoea can quickly become serious and, if not treated, lead to death.

Diarrhoea can have many causes. It may be a symptom of disease or a side-effect of medicines and is often caused by contamination of food because of food hygiene problems. It can be made worse by eating certain foods.

Many people mistakenly believe that with diarrhoea they should stop eating and drinking and take medicines. However, reducing food intake may make the problem more serious. Discuss the use of anti-diarrhoeal medicine with a health worker or doctor. Do not use medicine prescribed for other people.

Diarrhoea is the body's way of removing poisonous materials from the gut. Even though most diarrhoea will cease after a few days, the best action is to drink lots of fluid (or the oral rehydration solution ORS) described in the box on p. 37-38, continue eating and treat any underlying cause, if known, until the diarrhoea ceases.

Most diarrhoea can be treated at home, following the simple instructions below. Seek advice from a health worker if it lasts for more than three days, if fever develops, blood appears in the stool, or if you become very weak.

Prevention is better than cure. Many cases of diarrhoea can be prevented by following the rules of hygiene given in Chapter five.

Do not stop eating when having diarrhoea; drink lots of fluids

General recommendations. Drink more than eight cups of fluid, particularly water, per day. It is also good to take fluid in other forms to replace the salts that have been lost and provide energy. Some suggestions are given below for easily digested foods and drinks that will help to rehydrate the body and provide salts, energy and vitamins.

Recommended foods and drinks. Drink soups, fruit juices diluted with water or an oral rehydration solution.

Foods and drinks to limit or avoid. Some foods can make diarrhoea worse. Try to remove one food at a time from the diet and see if it makes a difference.

A person should drink as often as possible throughout the day and night and every time a stool is passed. An adult normally needs about 1.5 litres or eight cups of fluid per day. In severe cases of diarrhoea this may be increased to up to three litres a day.

Preparing an oral rehydration drink

From packets
Follow the instructions and dissolve the contents of the packet in the amount of clean water that is stated on the packet.

With sugar and salt
To one litre of clean water, add half a teaspoon of salt and eight teaspoons of sugar. Stir or shake well. The water should taste no more salty than tears.

With powdered cereals
To one litre of clean water, add half a teaspoon of salt and eight teaspoons of powdered cereals. Rice is best, but fine ground wheat flour, maize, sorghum or cooked mashed potatoes can also be used. Boil for 5-7 minutes to make a liquid soup or watery porridge. Cool the drink quickly.


Poor appetite is one of the most common problems in people with HIV/AIDS. It can have many causes including infections, pain (particularly in the mouth or gut), depression, anxiety, tiredness or poor nutritional intake. The feeling of hunger may disappear or the person may be easily satisfied and therefore not want to eat enough. However, it is very important to continue eating to prevent weight loss and malnutrition and to maintain strength in order to speed recovery.

When not hungry … the best way to regain appetite is to eat


Nausea reduces the appetite and can be caused by certain foods, hunger, infections, stress and lack of water. It can also be a side-effect of medicines although certain medicines can help to relieve nausea. A health worker will provide advice.

If vomiting occurs, the body will lose water and will dehydrate even more quickly. If a person is too sick to eat, small and frequent drinks of water, fruit juice and vegetable soups may help (see Annex 1).

How to deal with nausea and vomiting

General recommendations

Recommended foods to eat and drink

Foods to avoid


Soreness of the mouth and tongue is common in people with HIV/AIDS. A sore mouth can make it difficult to eat, thus reducing food intake.

How to deal with a sore mouth

Foods and drinks to avoid


People with HIV/AIDS may have problems in digesting certain foods or may suffer from constipation and bloating. These problems are caused by damage to the naturally occurring bacteria in the intestine, which are needed to digest food. These bacteria may be destroyed by antibiotics or other medicines.

How to deal with these problems

General recommendations

Foods to avoid

How to stop constipation

How to prevent a bloated feeling


As a result of drug side-effects and infections, people may find that foods have a different taste or texture from usual. They may develop cravings for food that they did not like in the past. However, these situations are common during illness.

How to deal with these changes


Skin problems such as rashes and sores are common in people suffering from HIV/AIDS. Other problems such as dry patches or poor healing of wounds may be related to malnutrition or specific micronutrient deficiencies.

Poor skin conditions can be caused by lack of vitamin A or vitamin B6. Although many skin problems may need specific medical treatment, the addition of foods rich in vitamin A and/or B6 to the diet may help to prevent skin problems or improve the condition over time. Good sources of vitamin A are yellow, orange and green vegetables and liver. Good sources of vitamin B6 are cereals, kernels, whole grains, seeds and nuts as well as figs and green leafy vegetables.


Colds and influenza (flu) are common virus infections that can cause a runny nose, sore throat, cough and sometimes fever. However, these infections almost always disappear without medicine.

How to deal with colds and flu

A cold normally lasts about a week. If it lasts longer, or other symptoms are present such as a high fever or a cough with a lot of mucus, blood or odorous discharge, see a health worker because there may be an underlying infection.


Coughing is how the body cleans the lungs and throat by getting rid of mucus and germs. Therefore, do not take any medicines to stop coughing but try to loosen the mucus.

Sore throat

A sore throat is usually caused by colds or flu and is normally not serious. However, if it persists for several weeks, see a health worker. The following may help to ease a sore throat.


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