Malnutrition among young children remains high in sub-Saharan Africa where poverty and the HIV epidemic synergistically undermine progress in child health that has been obtained in other regions of the world. HIV may indirectly influence children's nutritional and health status by altering household food security, caregiving practices (such as, breastfeeding), and health-seeking practices. The knowledge gap concerning these mechanisms limits the ability of health professionals to effectively develop and promote services and practical and sustainable recommendations that will support child health, growth, and survival in communities affected with the HIV epidemic. This grant incorporates training and research activities in the area of nutrition and HIV in Ghana. Our long-range goal is to enhance the institutional capacity to provide local training and research opportunities that will lead to policy recommendations and program development for the improvement of the lives of individuals living in communities affected by HIV. The main objectives are: 1) to provide postgraduate training in maternal and child nutrition within the context of HIV through formal US academic programs and intensive short courses in Ghana, and 2) to conduct a pilot study on the mechanisms by which HIV infection indirectly influences child health. The central hypothesis is that the presence of HIV infection in the household increases the risk of childhood malnutrition and mortality through increased food insecurity, decreased time for caregiving practices, and modified expectations of normal child health and well-being. Extensive social networks may mitigate this effect by offering alternative resources to children. The central hypothesis will be tested with 302 women and their newborns who will be followed for one year to collect data on feeding, health, growth, household demographic and socioeconomic characteristics, and family's use of social networks. All women will have used a voluntary testing center for HIV; half of the enrolled mothers will be positive for HIV and the other half will be negative. Statistical analyses will provide an estimate of the effect of HIV on outcomes of infants who are infected and not infected with the virus. These results will provide the knowledge needed to develop appropriate, effective programs and recommendations that will improve child health.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Resource-Related Research Projects (R24)
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Special Emphasis Panel (ZHD1-DSR-A (03))
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Haverkos, Lynne
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Iowa State University
Other Domestic Higher Education
United States
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Lartey, Anna; Marquis, Grace S; Mazur, Robert et al. (2014) Maternal HIV is associated with reduced growth in the first year of life among infants in the Eastern region of Ghana: the Research to Improve Infant Nutrition and Growth (RIING) Project. Matern Child Nutr 10:604-16
Garcia, Jonathan; Hromi-Fiedler, Amber; Mazur, Robert E et al. (2013) Persistent household food insecurity, HIV, and maternal stress in peri-urban Ghana. BMC Public Health 13:215
Okronipa, Harriet E T; Marquis, Grace S; Lartey, Anna et al. (2012) Postnatal depression symptoms are associated with increased diarrhea among infants of HIV-positive Ghanaian mothers. AIDS Behav 16:2216-25
Addo, Adolphina A; Marquis, Grace S; Lartey, Anna A et al. (2011) Food insecurity and perceived stress but not HIV infection are independently associated with lower energy intakes among lactating Ghanaian women. Matern Child Nutr 7:80-91
Otoo, Gloria E; Marquis, Grace S; Sellen, Daniel W et al. (2010) HIV-negative status is associated with very early onset of lactation among Ghanaian women. J Hum Lact 26:107-17
Otoo, Gloria E; Lartey, Anna A; PĂ©rez-Escamilla, Rafael (2009) Perceived incentives and barriers to exclusive breastfeeding among periurban Ghanaian women. J Hum Lact 25:34-41
Aryeetey, Richmond N O; Marquis, Grace S; Brakohiapa, Lucy et al. (2009) Subclinical mastitis may not reduce breastmilk intake during established lactation. Breastfeed Med 4:161-6
Aryeetey, Richmond N O; Marquis, Grace S; Timms, Leo et al. (2008) Subclinical mastitis is common among Ghanaian women lactating 3 to 4 months postpartum. J Hum Lact 24:263-7