Descriptive Characteristics and Health Outcomes of the Food by Prescription Nutrition Supplementation Program for Adults Living with HIV in Nyanza Province, Kenya Jason M. Nagata 1 *, Craig R. Cohen 2 , Sera L. Young 3 , Catherine Wamuyu 4 , Mary N. Armes 4 , Benard O. Otieno 4 , Hannah H. Leslie 5 , Madhavi Dandu 6 , Christopher C. Stewart 7 , Elizabeth A. Bukusi 4 , Sheri D. Weiser 8 1 School of Medicine, University of California, San Francisco, San Francisco, California, United States of America, 2 Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America, 3 Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America, 4 Family AIDS Care and Education Services, Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya, 5 Division of Epidemiology, University of California, Berkeley, Berkeley, California, United States of America, 6 Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, United States of America, 7 Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America, 8 Division of HIV/AIDS, University of California, San Francisco, San Francisco, California, United States of America Abstract Background: The clinical effects and potential benefits of nutrition supplementation interventions for persons living with HIV remain largely unreported, despite awareness of the multifaceted relationship between HIV infection and nutrition. We therefore examined descriptive characteristics and nutritional outcomes of the Food by Prescription (FBP) nutrition supplementation program in Nyanza Province, Kenya. Methods: Demographic, health, and anthropometric data were gathered from a retrospective cohort of 1,017 non-pregnant adult patients who enrolled into the FBP program at a Family AIDS Care and Education Services (FACES) site in Nyanza Province between July 2009 and July 2011. Our primary outcome was FBP treatment success defined as attainment of BMI.20, and we used Cox proportional hazards to assess socio-demographic and clinical correlates of FBP treatment success. Results: Mean body mass index was 16.4 upon enrollment into the FBP program. On average, FBP clients gained 2.01 kg in weight and 0.73 kg/m 2 in BMI over follow-up (mean 100 days), with the greatest gains among the most severely undernourished (BMI ,16) clients (p,0.001). Only 13.1% of clients attained a BMI.20, though 44.5% achieved a BMI increase $0.5. Greater BMI at baseline, younger age, male gender, and not requiring highly active antiretroviral therapy (HAART) were associated with a higher rate of attainment of BMI.20. Conclusion: This study reports significant gains in weight and BMI among patients enrolled in the FBP program, though only a minority of patients achieved stated programmatic goals of BMI.20. Future research should include well-designed prospective studies that examine retention, exit reasons, mortality outcomes, and long-term sustainability of nutrition supplementation programs for persons living with HIV. Citation: Nagata JM, Cohen CR, Young SL, Wamuyu C, Armes MN, et al. (2014) Descriptive Characteristics and Health Outcomes of the Food by Prescription Nutrition Supplementation Program for Adults Living with HIV in Nyanza Province, Kenya. PLoS ONE 9(3): e91403. doi:10.1371/journal.pone.0091403 Editor: Javier R. Lama, Asociacion Civil Impacta Salud y Educacion, Peru Received July 15, 2013; Accepted February 11, 2014; Published March 19, 2014 Copyright: ß 2014 Nagata et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This study was funded by the University of California, San Francisco Pathways Explore Grant, the University of California, San Francisco Library Open Access Publishing Fund, and the Phi Beta Kappa, Northern California Association, Scholarship (JN), the National Institutes of Health R01 MH095683 (SW), and the National Institute of Mental Health K01 MH098902 (SY). Competing Interests: The authors have declared that no competing interests exist. * E-mail: jasonmnagata@gmail.com Introduction The human immunodeficiency virus (HIV), undernutrition, and food insecurity remain leading causes of morbidity and mortality in sub-Saharan Africa despite increases in international funding for care and improved access to highly active antiretroviral therapy (HAART) [1,2]. Undernutrition and food insecurity converge to exacerbate the detrimental health consequences of HIV through complex feedback cycles [1,3] and disproportion- ately affect the estimated 22.5 million persons living with HIV/ AIDS in sub-Saharan Africa [4]. HIV infection amplifies undernutrition by weakening metabolic function through impaired storage and utilization of nutrients, reduced absorption of carbohydrates and fats (including fat-soluble vitamins), and recurrent diarrhea from compromised immunity [1,5]. In addi- PLOS ONE | www.plosone.org 1 March 2014 | Volume 9 | Issue 3 | e91403