Getting the Knack of NACS: Highlights from the State of the Art Meeting on Nutrition Assessment, Counseling and Support (NACS) HIV/AIDS, Nutrition, and Food Security What We Can Do

HIV

See Also: Emergency Nutrition; Food Aid; Food Security

Food and nutrition interventions are critical components of a comprehensive response to the HIV pandemic. HIV compromises the nutritional status of infected individuals, and malnutrition in turn can worsen the effects of the disease. Nutrition interventions can help break this cycle by helping people living with HIV (PLHIV) manage symptoms, reduce susceptibility to opportunistic infections, improve nutritional status, promote response to medical treatment, and improve overall quality of life. The HIV pandemic also significantly compromises the food security of affected households and communities, reducing the availability of productive labor, diverting income, depleting savings and productive assets, overwhelming social networks and safety nets, and impeding intergenerational knowledge transfers. In some contexts, food insecurity may lead to more migratory livelihood strategies and high-risk sexual behaviors that increase the risk of HIV transmission.

With support from USAID and the President's Emergency Plan for AIDS Relief (PEPFAR), FANTA-2 provides technical assistance to strengthen nutrition assessment, counseling, and support (NACS) for PLHIV and improve food assistance and food security programming in the context of HIV. FANTA-2 produces and disseminates program guidance on nutritional care and support interventions, the nutrient requirements of PLHIV, and food and nutrition implications of antiretroviral therapy (ART). FANTA-2 and its partners help countries in east and southern Africa to adapt and apply HIV-nutrition guidance to their specific contexts through national guidelines, training curricula and programs, counseling materials, monitoring and evaluation support, and capacity building activities. In Kenya, Namibia, Rwanda, Uganda, and Zambia, FANTA-2 provides in-country support to integrate and scale up nutrition interventions in HIV services.

To strengthen the evidence base about the impacts of food supplementation on malnourished PLHIV, FANTA-2 is supporting randomized controlled evaluations in Malawi and Kenya.

FANTA-2 works with partners to strengthen food security and food assistance responses to the pandemic. Through its technical assistance to USAID's Office of Food for Peace and implementing partners, FANTA-2 supports improved program design and monitoring and evaluation of food-assisted programs addressing HIV and its impacts.

	A brief description of each publication is provided below. By choosing the publication title, you are able to read a detailed description and to download the publication.

1. Ghana HIV and Nutrition Job Aids (2011): The Ghana Nutrition and HIV job aids assist clinicians and community health workers working in inpatient and outpatient HIV services to assess nutritional status and provide critical nutrition actions and information to people living with HIV.  The job aids complement trainings in nutrition assessment, counseling, and support (NACS) in Ghana, and were developed through a collaborative process with the Ghana Health Service (GHS) nutrition department.  Testing at initial pilot sites showed that the job aids were found to be useful not only by clinicians but also by counselors, expert clients, and others.

2. Nutrition Counseling for People Living with HIV and/or Tuberculosis in Cote d’Ivoire: Flipchart and Flipchart User's Guide (2011): To help facility-based providers and community counselors promote the uptake of key nutrition behaviors among people living with HIV (PLHIV) and/or tuberculosis in Cote d’Ivoire, FANTA-2 completed the nutrition counseling materials, Conseils en Nutrition Pour Les PVVIH et/ou Malades de la Tuberculose (Nutrition Counseling for PLHIV and/or Tuberculosis),and developed an accompanying user’s guide, Guide D’Utilisation de la Boite a Images Pour le Conseil en Nutrition Des Personnes Infectees et Affectees Par le VIH et/ou Malades de la Tuberculose (Guide to Using the Flipchart for Nutrition Counseling for Persons Infected or Affected by HIV and/or Tuberculosis).

3. Toolkit: For Countries Applying for Funding of Food and Nutrition Programs Under the Global Fund to Fight AIDS, Tuberculosis and Malaria (Round 11) (2011): The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) is the largest multilateral donor funding services for people living with HIV, people affected by HIV and AIDS, and people with active tuberculosis. An inter-agency team, consisting of WFP, WHO, PEPFAR, and FANTA-2, worked to create this toolkit in order to strengthen Round 11 proposals for Global Fund funding. The toolkit can be used by countries considering inclusion of food and nutrition activities for the first time and by experienced countries that want to scale up their response or broaden the range of their food and nutrition support activities to address emerging problems. It provides potential Round 11 applicants with the information needed to include a food and nutrition component in their Global Fund proposals, have food and nutrition more consistently integrated into them, and improve the overall quality of their applications.

4. Materials for Mozambique's Nutrition Rehabilitation Program (2011): FANTA-2 was one of a group of partners that assisted the Mozambique Ministry of Health in developing national protocols, training materials, and job aids for the national Nutrition Rehabilitation Program (Programa de Reabilitação Nutricional [PRN]). The PRN is based on the Community-Based Management of Acute Malnutrition (CMAM) approach. The Manual for Nutrition Treatment and Rehabilitation, Volume I (Manual de Tratamento e Reabilitação Nutricional, Volume I) contains protocols for the treatment of acute malnutrition for children 0–15 years with or without HIV and/or tuberculosis. The manual is accompanied by job aids, which are aimed at helping implementation of inpatient and outpatient treatment. The Facilitators Training Guide and Participants Handouts are used to train health facility staff and community-based health workers. All materials are in Portuguese.

5. Challenges for Safe Replacement Feeding among HIV-Positive Mothers in Hai Phong and Ho Chi Minh City, Vietnam: A Qualitative Study of Mothers, Fathers, Health Care Providers, and Other Experts (2011): A report of the results from a study of infant and young child feeding (IYCF) practices among HIV-positive women in two Vietnamese cities with high HIV prevalence, Hai Phong and Ho Chi Minh City. The study’s primary purpose was to determine whether HIV-positive women could safely follow the advice of health care providers to provide replacement feeding to their infants. The report is accompanied by a research note that summarizes the study findings and recommendations.

6. Zambia Nutrition Guidelines for Care and Support of People Living with HIV and AIDS, and Zambia Counseling Flipchart – Eating and Living Well with HIV and AIDS: Good Nutrition Makes a Difference (2011): Zambia’s Ministry of Health, National AIDS/AIDS/STI/TB Council, and National Food and Nutrition Commission worked with partners to revise the 2004 Nutrition Guidelines for Care and Support of People Living with HIV and AIDS and 2006 flipchart Eating and Living Well with HIV and AIDS: Good Nutrition Makes a Difference to provide updated information to individuals and organizations on nutrition assessment, counseling, and support (NACS) for people living with HIV (PLHIV). The updates to the guidelines and the flipchart harmonize the entry and exit criteria for nutrition product support between the existing Integrated Management of Acute Malnutrition (IM-AM) program and the NACS program.

7. Anthropometry: Assessing Children Under 5 Bookmark (2011): FANTA-2 has produced a bookmark that presents clear information on the anthropometry used to assess the nutritional status of children under 5 years of age. Common definitions, cutoffs, and classifications are detailed in an easy-to-use format. This bookmark replaces the FANTA bookmarks published from 2002 through 2006, and is available in multiple languages.

8. Meeting on Nutrition Assessment, Counseling, and Support in HIV Services: Strategies, Tools, and Progress, September 14–17, 2010, Jinja, Uganda, Meeting Report (2011): Ninety-eight participants from 18 countries met to share tools and experiences and to disseminate promising approaches in nutrition assessment, counseling, and support (NACS) programming. NACS is the primary model supported by the United States President’s Emergency Fund for AIDS Relief (PEPFAR) for integrating nutrition services into clinical HIV care and treatment services. The meeting report details the meeting objectives, processes, and key issues identified. 

9. National Guidelines for Food and Nutritional Care and Support of People Living With HIV in Haiti with accompanying counseling flipchart (2010): The guidelines and flipchart provide practical information and guidance to help people living with HIV (PLHIV) to maintain healthy nutrition status and nutritionally manage symptoms of HIV, side effects of ART and opportunistic infections. The guidelines provide recommendations for healthy and well balanced diets for PLHIV along with instructions for quality nutrition counseling of adolescent and adult PLHIV, HIV-positive pregnant and lactating women, and caregivers of children exposed to HIV.  The guidelines also address food insecurity in HIV-affected households. The guidelines are only available in French and the flipchart is only available in Haitian Créole. 

10. Namibia's Nutrition Assessment, Counselling and Support for PLHIV Operational Guidelines (2010): Based on a 2008 assessment’s findings, FANTA helped the Ministry of Health and Social Services (MOHSS) develop a strategy and operational plan on nutrition and HIV that defines the components of and resource needs for a PEPFAR-funded Food By Prescription program for PLHIV. The guidelines serve as the framework for planning, resource mobilization and monitoring of nutrition care and support implementation.

11. Nutrition and HIV Counseling Materials and Job Aids for Namibia (2010): FANTA-2 worked with the Government of Namibia and partners to develop counseling materials and job aids to support nutrition care and support for people living with HIV (PLHIV). The materials include job aids for nurses and physicians, and client education materials on nutrition management of HIV-related symptoms and on food and water safety and hygiene. These materials will be distributed to HIV care and treatment sites.

12. Côte d’Ivoire National Guidelines for the Nutrition, Care and Support of People Living with HIV and/or Tuberculosis (2010): FANTA-2 collaborated with Côte d’Ivoire’s Ministry of Health and other partners to develop national guidelines for the nutritional care and support for people living with HIV (PLHIV) and/or tuberculosis.

13. Guide to Screening for Food and Nutrition Services Among Adolescents and Adults Living with HIV (2010): Recognizing the important role food and nutrition play in comprehensive care of people living with HIV (PLHIV), countries and programs are increasingly integrating food and nutrition services into HIV care and treatment programs. As HIV care and treatment programs scale up food and nutrition services among PLHIV, implementing agencies have expressed the need for guidance on how to screen PLHIV who need food and nutrition services. The guide provides direction on how to screen HIV-infected older adolescents and adults who need food and nutrition services.

14. Assessment Report on the Integration of Nutrition, Food and HIV Programming in Côte d’Ivoire (2009): Formerly called “Food by Prescription” (FBP), nutrition assessment, counseling, and support (NACS) has become an effective and replicable approach for meeting the nutritional needs of malnourished people living with HIV in clinical settings, significantly enhancing the care and treatment provided. In 2009, FANTA drafted a strategy for Côte d’Ivoire to guide selection of NACS program sites, program scale-up, selection and procurement of specialized food products, development of eligibility and exit criteria, targeting, and staffing and capacity strengthening.

15. Review of Kenya's Food by Prescription Programme (2009): The review examines the operation and effectiveness of the program with a focus on specific issues such as the duration of food supplementation, loss to follow-up among clients, changes in client nutritional status and the food delivery system.

16. Nutrition Care and Support of People Living with HIV in Countries in Francophone Africa: Progress, Experience, and Lessons Learned (2009): Nutrition Care and Support of People Living with HIV in Countries in Francophone Africa: Progress, Experience, and Lessons Learned presents the results of a 2008 review of progress in integrating nutrition into the HIV care and support in 18 francophone countries in western and central Africa. This report was prepared for and presented at the Ouagadougou (Burkina Faso) WHO Consultation on Nutrition and HIV in November 2008.

17. Ethiopia Nutrition and HIV Tools (2008): To improve care and treatment for people living with HIV, FANTA worked with the Federal Democratic Republic of Ethiopia Ministry of Health and partners to develop the following resources: the National Nutrition and HIV/AIDS Implementation Reference Manual, which provides a national operational strategy for nutrition and HIV interventions; the Clinical Nutrition Care for Children and Adults with HIV Trainer and Trainees Guides, which are Ethiopia's national training materials on nutrition and HIV for health care workers; Nutrition and HIV Behavior Change Communication Tools, a set of job aids, counseling cards and other materials for health care workers to use for nutrition assessment and counseling and an updated version of National Guidelines on HIV/AIDS and Nutrition. These materials provide guidance and tools that health care workers in Ethiopia are using to incorporate nutrition into a range of community and facility-based HIV services.

18. Nutrition, Food Security and HIV: A Compendium of Promising Practices (2008): Increasingly, countries in east, central, and southern Africa are integrating nutrition and food security interventions into HIV services. As the number, variety and reach of these programs expand, identification and documentation of promising practices become valuable in order to help understand what works, replicate successful approaches and incorporate lessons into programs. The Regional Centre for Quality of Health Care (RCQHC) in Uganda and the FANTA Project organized extensive in-country reviews by local teams of nutrition, food security and HIV programs in Kenya, Malawi, Tanzania, Uganda, and Zambia. Nutrition, Food Security and HIV: A Compendium of Promising Practices compiles, analyzes and describes the promising practices identified through the reviews.

19. Nutrition Care for People Living with HIV and AIDS: Training Manual for Community and Home-Based Care Providers' Facilitators Guide and Participant Handouts (2008): The training manual and accompanying participant handouts are designed to equip community and home-based care providers with sufficient knowledge and skills to provide nutrition care to PLHIV as part of ongoing services. The materials are designed for training providers who do not have extensive education or technical knowledge. Topics include the relationship between nutrition and HIV, assessment of nutritional status, methods for improving food intake, management of HIV and AIDS complications, managing food and drug interactions, care for HIV-positive women and children, food and water safety and hygiene, and principles of counseling and networking.

20. Strengthening Agricultural Technologies among People Living with HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda (2008): In 2007 and 2008, FANTA worked with Family Health International's Regional Outreach Addressing AIDS through Development Strategies (ROADS) Project and with the Regional Centre for Quality of Health Care to support the identification, diffusion and application of appropriate technologies in two border towns of Kenya and Uganda to improve the productivity of PLHIV agricultural activities. The report recommends identifying simple agricultural technologies and applying them through linkages between PLHIV support groups and local agricultural institutions.

21. Nutrition and HIV/AIDS: A Training Manual for Nurses and Midwives (2008): Nutrition and HIV/AIDS: A Training Manual for Nurses and Midwives is designed to provide nursing school instructors with materials that they can use to teach nursing students the knowledge and skills needed for nutrition care and support of PLHIV. While designed to be used for pre-service training, it can also be used or adapted for in-service training.

22. A Guide to Monitoring and Evaluation of Nutrition Assessment, Education and Counseling of People Living With HIV (2008): This publication provides guidance and tools to support programs in monitoring and evaluating nutrition interventions for people living with HIV (PLHIV). It is designed for use by program managers, M&E officers and other program and government health system staff who are responsible for designing and implementing M&E systems. The guide can be used to select indicators, set targets, plan data collection and tabulation processes and interpret and use the information obtained.

23. Kenya Trainer Manual and Trainee Toolkit for Nutrition in Comprehensive Care Centers (2007): To strengthen the capacity of HIV service providers to provide effective nutritional care and support, USAID/Kenya supported FANTA in working with the Government of Kenya's National AIDS and STI Control Program (NASCOP) to develop a trainer manual and trainee tools for a Kenya national training course on nutrition and HIV for service providers from Comprehensive Care Centers (CCC), the health care facilities where HIV patients are treated. FANTA also conducted trainings of CCC service providers using the training course.

24. Food Assistance Programming in the Context of HIV (2007): Food Assistance Programming in the Context of HIV, a joint publication by WFP and FANTA, is a guide developed to improve the design and implementation of food security programs that respond to HIV-related challenges as well as HIV programs that utilize food and food-related activities to achieve HIV-related outcomes. The guide provides a set of tools, promising practices and key considerations that enhance the flexibility and appropriateness of program design and implementation modalities, and has been developed for program directors, program advisors and senior program managers who are directly involved in the analysis and formulation of food assistance strategies and country program activities at HQ and in regional and field offices.

25. Recommendation for the Nutrient Requirements for People Living with HIV/AIDS (2007): Based on the report of the May 2003 WHO technical consultation on nutrient requirements for people living with HIV/AIDS, this document provides information about the nutrient requirements of people living with HIV in a concise, two-page format.

26. National Guidelines and Protocol for Nutritional Support and Care for People Living with HIV/AIDS in Rwanda (2006): As a part of the Rwanda Nutrition Working Group, FANTA assisted in the development of National Guidelines on Nutritional Care and Support for People Living with HIV/AIDS in Rwanda. These guidelines were developed to define the actions that service providers need to take to provide quality nutritional care and support to people living with HIV, supplement national policies on prevention and treatment, and strengthen and standardize care and support for PLHIV across organizations, programs and services. The Rwanda Nutrition Working Group also developed an abbreviated version of the National Guidelines, referred to as the National Protocol for the Nutritional Care and Support of People Living with HIV/AIDS in Rwanda, for front-line health service providers.

27. Rwandan HIV and Nutrition Wall Chart & Counseling Cards (2006): FANTA, in collaboration with Treatment and Research AIDS Center, Rwanda (TRAC), has produced and distributed the HIV and Nutrition Wall Chart and Counseling Cards. Produced in Kinyarwanda, the charts focus on 10 messages related to healthy eating and lifestyles and proper care for PLHIV. The wall chart has also been translated into English and French, and both the wall chart and flip chart files are available for download.

28. Kenyan National Guidelines on Nutrition and HIV/AIDS (2006): With funding from USAID/Kenya, the FANTA Project provided technical assistance to the National AIDS and STI Control Programme (NASCOP) in the Kenya Ministry of Health to develop Kenyan National Guidelines on Nutrition and HIV/AIDS. The national guidelines support the 2005-2010 Kenyan National HIV/AIDS Strategic Plan, in which the Government of Kenya has identified nutrition as a key component of the national response to the HIV/AIDS epidemic. The national guidelines establish a consistent set of nutrition recommendations for people living with HIV/AIDS (PLWHA) and describe actions that service providers need to take to provide nutritional care. Topics covered include nutrient needs of PLWHA, critical nutrition actions for PLWHA, nutritional care for those taking ARVs and other drugs, nutritional management of symptoms, food security, and nutritional care for children and pregnant and lactating women living with HIV/AIDS.

29. Food and Nutrition Implications of Antiretroviral Therapy in Kenya: A Formative Assessment (2005): A formative assessment was undertaken to increase understanding of the food and nutrition needs of clients on ART and the kind of messages that maybe needed by service providers to integrate nutrition in ART care. The study was conducted by a consultant, in partnership with a team from NASCOP, at 13 facilities in 5 sites in Kenya including public, private and mission hospitals, as well as NGOs and networks of PLHIV were visited. The report discusses findings and recommendations related to food and nutrition needs of ART clients, gaps in program capacity, and client and provider perceptions about the role of food and nutrition in ART. FANTA presented the findings in the report to representatives from the Government of Kenya and its PVO partners and disseminated it among government and private stakeholders to assist the government and PVOs in creating strategies to strengthen ART services in Kenya.

30. Counseling Materials for Nutritional Care and Support of People Living with HIV/AIDS (2005): Produced by the Regional Centre for Quality of Health Care with technical and financial support from FANTA and LINKAGES and funding from USAID/REDSO, these materials are for use by counselors and service providers to support nutritional care and support for people living with HIV/AIDS (PLWHA). The materials were developed with a focus on Uganda and are being used and adapted in other countries as well.

31. Zambia Nutrition Guidelines for the Care and Support of People Living with HIV/AIDS (2005): Zambia has been hard hit by the HIV/AIDS pandemic. Based on a 2001-2002 population-based survey, the national HIV/AIDS prevalence was estimated at 16%. Knowing the importance of good nutrition, the Government of Zambia initiated development of guidelines to provide information to individuals and organizations on the nutritional care and support for people living with HIV and AIDS (PLWHA). With support from USAID/Lusaka, FANTA provided technical assistance to a team lead by the National Food and Nutrition Commission (NFNC) to complete and disseminate these guidelines.

32. Workshop on HIV/AIDS and Food Aid: Assessment for Regional Programs and Resource Integration, November 2004: FANTA and the Regional Centre for Quality of Health Care (RCQHC) convened an "HIV/AIDS and Food Aid: Assessment for Regional Programs and Resource Integration" workshop in Entebbe, Uganda November 2-5, 2004. The workshop was funded by USAID’s Regional Economic Development Services Office for East and Southern Africa’s (REDSO). The objectives of the workshop were to improve understanding of food aid programming in the context of HIV/AIDS, strengthen capacity to assess the need for food aid interventions in HIV/AIDS-affected communities, and plan assessment activities that might identify opportunities for integrating food aid interventions into REDSO’s Transport Corridor Initiative (TCI). In addition, the workshop sought to assess partner needs for regional technical or other assistance to strengthen food aid programming addressing HIV/AIDS, including identifying and sharing lessons and promising practices. There were 51 participants at the workshop including PVOs implementing food aid programs in east or central Africa; REDSO HIV/AIDS implementing partners that seek to integrate or coordinate with food-based interventions in the transport corridor; World Food Program (WFP) regional and country office representatives; USAID Washington, regional and country Mission representatives from Offices of HIV/AIDS, Food for Peace and Poverty Analysis and Social Safety Net; Famine Early Warning System Network (FEWS NET); FANTA and RCQHC.

33. HIV/AIDS: A Guide for Nutritional Care and Support 2004: This guide (revised 2004) provides information for HIV/AIDS-affected households and communities on how nutrition can help HIV-positive people live healthier lives throughout the progression of HIV disease. Malnutrition is a common complication of HIV infection and plays a significant and independent role in its morbidity and mortality. Malnutrition was one of the earliest complications of AIDS to be recognized and has been used to clinically diagnose AIDS.

34. Food and Nutrition Implications of Antiretroviral Therapy in Resource Limited Settings (2004): As access to antiretroviral (ARV) therapy increases in developing countries, a greater number of HIV-infected individuals living in resource limited settings are able to use the drugs to extend the length and improve the quality of their lives. Interactions between ARVs and food and nutrition can significantly influence the success of therapy by affecting drug efficacy, adherence to drug regimens, and nutritional status. This Technical Note examines the relationship between nutrition and ARV efficacy, especially in resource limited settings. The document, which was supported by USAID’s Regional Economic Development Services Office for East and Southern Africa (REDSO/ESA), describes the effects of specific food-drug combinations in HIV/AIDS treatment and presents nutrition guidelines for ARV program design and management.

35. Nutrition and HIV/AIDS: Evidence, Gaps, and Priority Actions (2004): This joint publication by the FANTA and SARA Projects outlines evidence, gaps and priority actions related to nutrition, and HIV and AIDS. The document outlines how HIV infection increases energy requirements, and how vitamin and mineral deficiencies may contribute to HIV progression. Other findings show where priority actions need to be taken. Nutrition counselling and support is needed for those living with HIV, as is nutritional management for HIV-related illnesses. This would include providing counselling through home-based care programmes, community efforts and clinical services so that individuals and households can use available foods to manage symptoms.

36. Nutrition and HIV/AIDS: A Training Manual (2003): Nutrition plays a critical role in comprehensive care and support for people living with HIV/AIDS. Nutritional interventions can help manage symptoms, promote response to medical treatment, slow progression of the disease, and increase the quality of life by improving daily functioning. To strengthen capacity to implement nutritional care and support in eastern and southern Africa, stakeholders in the region identified the need to improve incorporation of nutrition and HIV/AIDS into pre-service training for doctors, nutritionists, and other health care workers in the region. Nutrition and HIV/AIDS: A Training Manual is intended to complement materials used in institutions of higher learning to improve the quality of training in nutrition and HIV/AIDS. The manual provides a comprehensive source of information on nutrition and HIV/AIDS, and provides instructors with technical content, presentations, practical exercises, and handout materials that can be used for planning and facilitating courses and lectures. The intended users of the manual are instructors of masters or undergraduate level students of medical or health sciences, applied human nutrition, dietetics or home economics, and food technology and agriculture. It is expected that students exposed to these materials will acquire enhanced knowledge and skills in the nutritional management of clients infected with HIV.

37. Nutritional Care and Support for People Living with HIV/AIDS in Uganda (2003): As part of FANTA's efforts to strengthen implementation of nutritional care and support for people living with HIV/AIDS, FANTA provided technical assistance in the development and application of national guidelines on nutrition and HIV/AIDS. With support from the USAID Mission in Uganda, FANTA assisted regional and national groups to develop national guidelines in Uganda, Nutritional Care and Support for People Living with HIV/AIDS in Uganda: Guidelines for Service Providers. These nationally adopted guidelines provide recommendations on the nutritional needs of PLWHA and on steps that service providers can take to help PLWHA manage symptoms and improve functioning through nutrition actions. With support from FANTA and the Regional Centre for Quality of Health Care, the guidelines were produced by the Uganda Ministry of Health STD/AIDS Control Programme and the Uganda Action for Nutrition, a national nutrition coalition.

38. Handbook: Developing and Applying National Guidelines on Nutrition and HIV/AIDS (2003): The handbook provides guidance for country teams and national AIDS control programs to develop and apply national guidelines on nutritional care and support of people living with HIV/AIDS. The handbook provides information on building a multi-sectoral team, adapting generic and country-specific materials to write national guidelines, integrating HIV/AIDS nutritional care and support into programs and services, and monitoring and evaluating the process and outcomes. With support from USAID/REDSO, FANTA works with regional partners in east and southern Africa to strengthen regional capacity in nutrition and HIV/AIDS. The handbook is the result of collaboration between FANTA and the Regional Centre for Quality of Health Care (RCQHC), based in Uganda. Content of the handbook is based on two regional workshops on national nutrition-HIV/AIDS guidelines that USAID/REDSO, RCQHC, FANTA, and UNICEF organized for teams from 11 countries in the region.

39. HIV/AIDS Mitigation: Using What We Already Know (2002): This technical note provides a summary of the literature on the impacts of HIV/AIDS on household and community food security and livelihood strategies in rural areas. It also presents a range of promising practices derived from the broader food-security and development experience that can be applied to HIV/AIDS mitigation efforts. The information presented below orients program staff about the critical socioeconomic impacts and constraints most likely experienced in HIV/AIDS-affected environments, and suggests appropriate program designs and modifications to mitigate the socioeconomic impacts of HIV/AIDS. This technical note is also intended for the wider development community to encourage multisectoral approaches to development programs in a HIV/AIDS context.

40. Potential Uses of Food Aid to Support HIV/AIDS Mitigation Activities in Sub-Saharan Africa (2000): This paper examines how food aid programs might support the US Agency for International Development's HIV/AIDS strategy and strengthen the ability of service providers and families to cope with the multiple impacts of HIV/AIDS. Possible options for strategies and interventions for using Title II food aid for HIV/AIDS mitigation are discussed. Situations where food aid may not be an appropriate option are identified along with some recommendations for action. The analysis and recommendations are based in part on interviews with food security and HIV/AIDS stakeholders in the United States, Kenya and Uganda in 1999, supplemented by a review of the literature on the impact of HIV/AIDS and coping strategies used by households and communities.

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*Please note that links to these sites do not imply that FANTA supports either the organization listed or the views and content presented.

Family Health International (FHI)
[http://www.fhi.org/en/hivaids/index.htm]
FHI's work in HIV/AIDS includes prevention research, program management and support, and technical services.

FAO's HIV/AIDS and Food Security Website
[http://www.fao.org/hivaids/]
The Food and Agriculture Organization's HIV/AIDS and food security site features FAO information related to HIV/AIDS and is intended to be a comprehensive resource for researchers, policy-makers, nongovernmental organizations and infected people.

FAO/WHO's "Living Well with HIV/AIDS: A Manual for Nutritional Care and Support for People Living with HIV/AIDS" (2003) [http://www.fao.org/DOCREP/005/Y4168E/Y4168E00.HTM]

Food Security and Food Policy Information Portal for Africa [http://aec.msu.edu/fs2/test/index.cfm?Lang=en]
This portal is still in development and aims to assist African food security and food policy networks in reaching out to country-level researchers and policy makers. It is made possible through a partnership between the United Nations Economic Commission for Africa (UNECA)'s Development Information Services Division (DISD) & Sustainable Development Division (SDD), African Food Security/Policy Networks & Michigan State University, Department of Agricultural Economics.

Global Health Council [http://www.globalhealth.org]
Their Global AIDS Program works to influence policy on AIDS activities and issues worldwide through educational advocacy and information exchange. The site includes HIV/AIDS news updates and access to its newsletter, AIDSLink.

Harvard AIDS Institute [http://www.aids.harvard.edu]
The AIDS Institute at Harvard University conducts AIDS research and provides online access to the latest developments in laboratory research, publications and conferences.

Microenterprise and HIV [http://hamed.seepnetwork.org]
Microenterprise and HIV is a new on-line community of practice linking Microenterprise Development Practitioners, the HIV community including PLHIV, public health professionals, programmers, and policy makers to address the challenge of HIV and AIDS together.

The President's Emergency Plan for AIDS Relief (PEPFAR)
[http://www.pepfar.gov/]

PEPFAR: Report on Food and Nutrition for People Living with HIV/AIDS, May 2006
[http://www.state.gov/documents/organization/66769.pdf]

PEPFAR: Policy Guidance on the Use of Emergency Plan Funds to Address Food and Nutrition Needs, September 2006
[http://www.state.gov/documents/organization/75859.pdf]

PEPFAR: U.S. Five-Year Global HIV/AIDS Strategy [http://2006-2009.pepfar.gov/about/c19380.htm]

Regional Centre for Quality of Health Care [http://www.rcqhc.org/]
The Regional Centre for Quality of Health Care exists to provide leadership in building regional capacity to improve quality of health care by promoting evidence based practices through networking, strategic partnerships, education, training and research. Better practices are defined as those that are effective, are institutionalized in Africa, have measured positive results, and are likely to be replicable.

UNAIDS [http://www.unaids.org]
UNAIDS, the Joint United Nations Programme on HIV/AIDS, is dedicated to strengthening and supporting an expanded response to prevent the transmission of HIV, provide care and support, reduce the vulnerability of individuals and communities to HIV/AIDS, and alleviate the impact of the epidemic. The site provides information about the epidemic, best practices. Many publications are accessible.

United Nations System Standing Committee on Nutrition (SCN) [http://www.unscn.org]
The United Nations System Standing Committee on Nutrition is the focal point for harmonizing the policies and activities on nutrition of the UN system. Its role is to serve as a coordinating mechanism, for exchange of information and technical guidance, and to act dynamically to help the UN respond to nutritional problems. The site provides links to SCN news and reports on nutrition worldwide.

US Agency for International Development's Webpage on HIV/AIDS [http://www.usaid.gov/our_work/global_health/aids]
USAID's Global Health Bureau works with the international health community and local partners to prevent the spread of HIV/AIDS. The site has information about USAID activities, links to related resources and relevant publications.

World Food Program's HIV Web Page [http://www.wfp.org/food_aid/food_for_hiv/index.asp? section=12&sub_section=2]

World Health Organization's HIV Web Page
[http://www.who.int/hiv/en/]

World Health Organization's "Scaling Up Antiretroviral Therapy in Resource Limited Settings: Treatment Guidelines for a Public Health Approach" (2003) [http://www.who.int/hiv/pub/prev_care/en/ ARVGuidelinesRevised2003.pdf]

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