Malnutrition and HIV infection are synergistically linked in a "vicious cycle," where each condition exacerbates the other, leading to poorer health outcomes, particularly among women. This article evaluates the effectiveness of establishing dedicated nutritional counseling services as an integral component of comprehensive care for HIV-positive women. The relevance of this intervention lies in its potential to improve clinical outcomes, enhance the effectiveness of antiretroviral therapy (ART), and improve the overall quality of life. This paper adopts a systematic review methodology to synthesize evidence from existing studies, structured to mirror a prospective program evaluation. The analysis focuses on key performance indicators, including changes in nutritional knowledge and dietary practices, as well as improvements in anthropometric and clinical markers (e.g., BMI, CD4 count, and ART adherence). The results consistently demonstrate that structured nutritional counseling leads to statistically significant improvements in dietary diversity, food safety knowledge, body mass index, and hemoglobin levels. Furthermore, the evidence strongly suggests a positive correlation between nutritional support and enhanced ART adherence, mediated by better management of treatment-related side effects. This paper concludes that nutritional counseling is a highly effective, feasible, and essential intervention. It recommends the formal integration of these services into national HIV care guidelines, adequate resource allocation for implementation, and standardized training for healthcare providers to ensure all HIV-positive women receive this vital support.

HIV, Nutritional Counseling, Women's Health, Program Evaluation, ART Adherence, Malnutrition, Health Outcomes, Dietary Practices

UNAIDS. (2023). Global HIV & AIDS statistics — Fact sheet. Retrieved from https://www.unaids.org/en/resources/fact-sheet

Scrimshaw, N. S., & SanGiovanni, J. P. (1997). Synergism of nutrition, infection, and immunity: an overview. The American Journal of Clinical Nutrition, 66(2), 464S-477S.

Anabwani, G., & Navario, P. (2005). Nutrition and HIV/AIDS in sub-Saharan Africa: an overview. Journal of Public Health in Africa, 2(1), 1-8.

Weiser, S. D., Tuller, D. M., Frongillo, E. A., Senkungu, J., Mukiibi, N., & Bangsberg, D. R. (2010). Food insecurity as a barrier to sustained antiretroviral therapy adherence in Uganda. AIDS and Behavior, 14(1), 129-136.

Koethe, J. R., & Heimburger, D. C. (2010). Nutritional aspects of HIV-associated wasting in sub-Saharan Africa. The American Journal of Clinical Nutrition, 91(4), 1138S-1142S.

Anastos, K., Lu, D., Shi, Q., Tien, P. C., Kaplan, R. C., Hessol, N. A., ... & Cohen, M. H. (2007). Association of race, HIV treatment history, and clinical characteristics with the risk of developing abnormal glucose metabolism among women. Journal of Acquired Immune Deficiency Syndromes, 46(4), 407-416.

World Health Organization. (2003). Nutrient requirements for people living with HIV/AIDS: report of a technical consultation. WHO.

Ivers, L. C., Cullen, K. A., & Freedberg, K. A. (2009). HIV/AIDS, undernutrition, and food insecurity. Clinical Infectious Diseases, 49(7), 1096-1102.

Palermo, T., Rawat, R., Weiser, S. D., & Kadiyala, S. (2013). Food access and diet quality are associated with quality of life outcomes among HIV-infected individuals in Uganda. PloS one, 8(4), e62353.

Normén, L., Chan, K., Braitstein, P., Anema, A., Bondy, G., Montaner, J. S., & Hogg, R. S. (2005). Food insecurity and hunger are prevalent among HIV-positive individuals in British Columbia, Canada. Journal of Nutrition, 135(4), 820-825.

Shisana, O., Zungu-Dirwayi, N., Toefy, Y., & Simbayi, L. C. (2004). Marital status and risk of HIV infection in South Africa. South African Medical Journal, 94(7), 537-543.

Kennedy, G., Ballard, T., & Dop, M. (2010). Guidelines for measuring household and individual dietary diversity. Food and Agriculture Organization of the United Nations.

Tiyou, A., Belachew, T., Alemseged, F., & Biadgilign, S. (2012). Food insecurity and associated factors among HIV-infected individuals receiving highly active antiretroviral therapy in Jimma zone, Southwest Ethiopia. Nutrition Journal, 11(1), 51.

McMahon, J. H., Wanke, C. A., Elliott, J. H., & Skinner, S. (2011). The impact of malnutrition on the course of HIV infection and the outcomes of antiretroviral therapy. AIDS Research and Treatment, 2011, 654628.

Mills, E. J., Nachega, J. B., Buchan, I., Orbinski, J., Attaran, A., Singh, S., ... & Cooper, C. (2006). Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA, 296(6), 679-690.