Exploring current nutritional programming and resources available to people living with HIV or AIDS in Canada: a scoping review
Authors: Mannette Jessica , Zhang Yingying , Rothfus Melissa , Purdy Chelsey , Tesfatsion Winta , Lynch Mary , Hamilton-Hinch Barbara , Williams Patricia L. , Joy Phillip , Grant Shannan 
Published: May 2023

Objective:
The objective of this scoping review is to map the current literature and resources available on nutrition and food programming for people living with HIV and AIDS in Canada. This review is phase 1 of a 4-phase project, called FoodNOW (Food to eNhance Our Wellness), a community-based nutritional needs assessment of people living with HIV or AIDS living in Nova Scotia, Canada.

Introduction:
People living with HIV or AIDS may experience nutritional challenges, including nutritional deficiencies associated with the virus, food insecurity, and nutrition-drug interactions. Nutritional programming is often required for optimal care for people living with HIV or AIDS. The literature, however, has not been sufficiently mapped to create a comprehensive picture of available programming. This review has informed the development of subsequent study phases, and will contribute towards shaping and planning food programs, as well as evaluating the need for subsequent systematic reviews.

Inclusion criteria:
This review has considered literature focused on nutrition and food programming and resources in Canada for people living with HIV or AIDS. People living with HIV or AIDS of any age, sex, race, gender identity, or sexual orientation, as well as pregnant and lactating people, have been included as the population of interest.

Methods:
The databases searched were MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premier (EBSCO), Social Services Abstracts (ProQuest), and Scopus. Sources of gray literature searched included government and organization websites, and Google searches. The database search was conducted in July 2021 and the gray literature searches were conducted in August and October 2021. Searches were limited to evidence published or translated in English. Two independent reviewers conducted title and abstract screening, and potentially relevant results were retrieved in full. Full-text screening and data extraction was conducted by 2 independent reviewers using a data extraction tool designed specifically for the scoping review objectives and research inclusion criteria, and any conflicts were resolved through discussion. Results are presented in both tabular and diagrammatic formats, with a narrative summary.

Results:
A total of 581 results were screened (published and gray literature). A total of 64 results were included in the review. The 6 reasons for exclusion at full-text review were: i) not nutrition and food programming (n= 83); ii) not Canadian (n= 37); iii) duplicates (n= 22); iv) not focused on people living with HIV or AIDS (n= 6); v) conference abstract (n= 1); and vi) not in English (n= 1). A total of 76 resources were located, as some of the 64 results included offered more than one resource. We have organized the 76 resources into 6 categories: i) charitable food provision (n = 21/76; 27.6%); ii) financial aid (n = 14/76; 18.4%); iii) nutrition care (n =12/76; 15.8%); iv) providing access to secondary sources (n= 10/76; 13.2%); v) food and nutrition expertise (n= 10/76; 13.2%); and vi) population health promotion (n= 9/76; 11.8%). Recommendations for future research and programming are discussed.

Conclusions:
This scoping review demonstrates that current programming relies heavily on charitable food provision services for people living with HIV and AIDS and that there is an unequal distribution of resources across Canada. Program expansion to target diverse populations with more equal distribution across Canada may improve overall health outcomes for people living with HIV and AIDS. Future research is needed to evaluate the effectiveness of available programming and the needs of end-users (people living with HIV and AIDS and their supports). FoodNOW will build on these findings to further explore and address the needs of people living with HIV and AIDS.

Details of the systematic review are available at:
Open Science Framework https://osf.io/97x3r