Cash or Food? Which Works Better to Improve Nutrition Status and Treatment Adherence for HIV Patients Starting Antiretroviral Therapy

Abstract

The overall objective of this DFID-funded study was to understand whether cash or food transfers were more effective for HIV-positive individuals starting antiretroviral therapy (ART) in improving nutrition, health status and adherence to ART. HIV-positive individuals initiating ART at the St Francis Mission Hospital in Katete District, Eastern Province, were randomly allocated to two treatment groups (cash and food), and given a food basket or its cash equivalent monthly, for eight months. Both treatment groups saw significant increases (p-value <0.001) in Body Mass Index (BMI), Household Dietary Diversity Score, good adherence to ART, and in mean CD4 count, but there were no significant differences between the two treatment groups in these measures. The study concluded that the provision of cash or food for eight months when clients start ART confers similar and significantly positive effects in improving clients’ nutrition and health. Providing cash is likely to be more cost-effective.