Psychosocial factors influencing preferences for food and nutritional supplements among people living with HIV in Bangkok, Thailand

Malnutrition and HIV are often coincident and may lead to wasting, a strong predictor of mortality. However; ready to use therapeutic foods (RUTF) are showing promising results in restoring the nutritional status of adult people living with HIV (PLHIV) in resource constrained settings but, its acceptability seems low. This study aimed to identify the psychosocial factors influencing general preferences for food and responses to five potential nutritional supplements to guide the development of novel products to treat malnutrition among PLHIV. This is a qualitative research based on Grounded Theory. In-depth interviews (IDIs) with a triangulation of data from different participants (i.e. PLHIV and Peer Counselors (PCs) were used as methods for data collection. During February-March 2013, 27 IDIs were conducted in the Anonymous Clinic of the Thai Red Cross and AIDS Research Center in Bangkok, Thailand. Five themes emerged: 1) local food culture is an important motive underlying the nutritional supplements choice by PLHIV; 2) food and drinks should have self-perceptible positive impact on health status and should be perceived convenient; 3) a soft and easy to swallow texture, softer scents and flavors are the major sensory characteristics guiding food and beverages choice; 4) food packaging characteristics affect nutritional supplement preference; 5) PCs may support nutritional supplement consumption. Similar findings emerged among PLHIV and PCs. This study highlights the need to develop a nutritional supplement considering the Thai culture and PLHIV's sensory preferences. A slightly thick liquid supplement, packed in small containers may be well-accepted. A combination of sensory studies and formative research should accompany the development of an alternative nutritional supplement for PLHIV. Results of this study might be transferable to similar sociocultural contexts.