Nutritional Status, ART Adherence, and Household Food Security among Children Living with HIV During the Covid-19 Pandemic in Urban Indonesia
Abstract
Background: In this study, we aimed to describe the nutritional status, antiretroviral therapy (ART) adherence, and household food security among children living with HIV (CLHIV) in the context of the COVID-19 pandemic. CLHIV are a vulnerable population facing clinical and socio-economic challenges that may affect treatment continuity and nutritional outcomes. The pandemic further disrupted access to food and healthcare services, particularly among low-income households. Methods: This cross-sectional study was conducted in DKI Jakarta, Indonesia, between 2021 and 2022. A total of 23 children living with HIV were included using purposive sampling. Data were collected through structured online interviews with parents or primary caregivers. Study variables included socioeconomic characteristics, nutritional status, antiretroviral therapy (ART) adherence, and household food security. ART adherence was assessed using the Adherence to Refills and Medications Scale (ARMS), while household food security was measured using the Food Insecurity Experience Scale (FIES). Nutritional status was classified based on national standards aligned with WHO growth references. Data were analyzed using descriptive statistics and Chi-square tests to assess associations between variables. Results: Among the participants, 43.5% of children had normal nutritional status, while 30.4% were undernourished and 26.1% were overweight. More than half of caregivers reported non-adherence to ART (56.5%), and 52.2% of households experienced food insecurity. A significant association was found between household income and nutritional status (p<0.05). Conclusion: Nutritional vulnerability, ART non-adherence, and household food insecurity remain prevalent among children living with HIV in this setting. Household economic conditions appear to play an important role in nutritional outcomes. However, these findings should be interpreted with caution due to the small sample size and cross-sectional design. Integrated interventions addressing medical care, nutrition, and socioeconomic support are needed. Future studies with larger samples and more robust designs are recommended.
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