Diet, Environment, and Choices of Positive Living (DECIDE Study): Evaluating Personal and External Food Environment influences on Diets among PLHIV and Families in Dar Es Salaam, Tanzania
People living with HIV (PLHIV) face high food insecurity and double disease burden because food insecurity leads to lower adherence to treatment and poor health outcomes, while long-term treatment puts them at a higher risk of obesity and dyslipidemia. Caregiving and social structures of food culture further marginalize women in these contexts. New research shows that there are strong gender dimensions to dietary intake, adequacy, and survival rates among PLHIV. However, a gap remains in documenting the various domains in which these differences emerge, including capacity to procure food, bargaining power, social norms, and appetite since diagnosis. Further, little is known about how an HIV diagnosis affects the dietary patterns of uninfected family members. In this “Diet, Environment, and Choices of positive living” – DECIDE study, we will use gender lens to explore and characterize the drivers of food choice, food environment, and dietary adequacy among PLHIV and their families in Dar es Salaam, Tanzania. Our multiple-method approach and study findings will provide a robust understanding of the underlying motivations behind dietary choices and patterns among PLHIV and their families. Such data will be useful in shaping nutritional guidelines and interventions to disrupt the impact of the double disease burden.
- Purdue University
- Africa Academy for Public Health
- University of Illinois, Chicago
- Harvard T.H. Chan School of Public Health
- Ramya Ambikapathi, PhD, MHS, Purdue University, Post-doctoral research fellow in the Department of Global Health and Population at Harvard T.H. Chan School of Public Health and Department of Nutrition Science.
- Japhet Killewo, MBchB, MSc, PhD, Professor of Epidemiology at Muhimbili University of Health and Allied Sciences
- Crystal L. Patil, PhD, Associate Professor and Department Head, Department of Women, Children and Family Health Science, University of Illinois at Chicago
- Mary Mwanyika Sando, MD, MPH, Chief Executive Officer of Africa Academy for Public Health
- Aloisia Shemdoe, MSc, MA, BA, Social Scientist at Africa Academy for Public Health Tanzania.
- Nilupa Gunaratna, MSc, PhD, Assistant Professor in the Department of Nutrition Science, Purdue University
- Ambikapathi R, Shively G, Leyna G, Mosha D, Mangara A, Patil CL, Boncyk M, Froesea SL, Verissimo CK, Kazonda P, Mwanyika-Sando M, Killewo J, Gunaratna NS. (2021). “Informal food environment is associated with household vegetable purchase patterns and dietary intake in the DECIDE study: Empirical evidence from food vendor mapping in peri-urban Dar es Salaam, Tanzania.” Global Food Security, 28, 100474, in press.
Posters & Presentations
- “Understanding drivers of food choice in changing food environments of low- and middle-income countries to inform program and policy” By Blake CE, Constantinides S, Turner C, Warren A, Ambikapathi R, Holdsworth M, Laar A, Sellen D, Frongillo E. 5th Agriculture, Nutrition & Health (ANH) Academy Week Learning Lab, June 24, 2020.
- “I have doubts”: Adult perspectives on food safety in peri-urban Tanzania By Patil C, Ambikapathi R, Gunaratna N, Killewo J, Leyna G, Sando M, Shemdoe A, Mosha D, Boncyk M, Froese S, Edwards C, Mangara A, Nyamsangia S, Kazonda P, Lackings B, Fawzi W. 5th Agriculture, Nutrition & Health (ANH) Academy Week, June 30 – July 2, 2020. ([pdf])
- “How does the food environment influence household food purchase patterns and nutritional status? Empirical evidence from food vendor mapping in peri-urban Dar es Salaam, Tanzania.” By Ambikapathi R, Gunaratna N, Shively G, Killewo J, Leyna G, Mwanyika-Sando M, Mosha D, Boncyk M, Froese S, Edwards C, Mangara A, Kazonda P, Patil C. 5th Agriculture, Nutrition & Health (ANH) Academy Week, June 30 – July 2, 2020. ([pdf])
- “What he likes depends on what is available”: Food Choices of PLHIV in Peri-Urban Tanzania By Boncyk M, Ambikapathi R, Shemdoe A, Patil CL, Froese S, Edwards C, Mosha D, Mwanyika-Sando M, Killewo JZ, Leyna GH, Gunarathna NS. 5th Agriculture, Nutrition & Health (ANH) Academy Week, June 30 – July 2, 2020.
- “Vulnerability to the COVID-19 Pandemic and Mitigation Measures among People Living with HIV in Peri-Urban Tanzania” By Gunaratna N, Killewo J, Mosha D, Ambikapathi R, Boncyk M, Shemdoe A, Mangara A, Kazonda P, Lyatuu I, Froese S, Edwards C, Patil C, Mwanyika-Sando M, Leyna G. 5th Agriculture, Nutrition & Health (ANH) Academy Week, June 30 – July 2, 2020. ([pdf])
- “Development and Feasibility of Tablet-based 24-hour Recall for Dietary Intake and Recipe Collection Among Adults and Children in Tanzania” (P10-018-19). By Ambikapathi R, Irema I, Lyaatu I, Mosha D, Nyamsangia S, Kajuna D, Kumalija E, Galvin L, Caswell B, Kazonda P, Leyna G, Killewo J, Patil C, Sando MM, Gunaratna N. American Society for Nutrition 2019 Annual Meeting, Baltimore, Maryland, 8-11 June 2019.
- Ambikapathi R, Killewo J, Patil CL, Sando MM, Shemdoe A, Gunaratna N, Leyna G. (2020). “Diet, Environment, and Choices of Positive Living (DECIDE study): Evaluating Personal and External Food Environment Influences on Diets Among PLHIV and Families in Dar es Salaam, Tanzania.”
- “Perspectives on Food safety as a driver of food choice in LMIC” By Shilpa Constantinides, Michelle Holdsworth, Amos Laar, Jessica Raneri, Crystal Patil, & Germana Leyna.