Background: Maintaining nutritional needs of People Living with HIV and AIDS (PLWHA) who are on Anti-Retroviral Treatment (ART) helps to strengthen their immune system and optimize response to medical treatment. The main objective of this study was to assess the nutritional status PLWHA on ART and the associated factors. Methodology: This was a cross-sectional study where 454 adolescent and adult PLWHA on ART were randomly selected and consent obtained to join the study. Structured interviewer-administered questionnaires were used to gather data on their socio-economic characteristics, the types of food consumed in the last 24 hours and their Body Mass Index. The data was organized and analysed using SPSS version 17.0. Variables were categorized and Chi-square statistical test used to assess association where a p-value of less than or equal to 0.05 was considered statistically significant. Results: A total of 454 PLWHA were recruited into the study and 180 (39.6%) were males while 274 (60.4%) were females giving a Male: Female ratio of 1: 1.5. Over three quarters (77%) had attained secondary education and above. The main sources of income were employment (48.5%) and business (44.9%). The types of foods consumed were beans and beef for body building (proteins); Ugali (maize meal) and rice for energy (Carbohydrates); kales and cabbages (vegetables), bananas and pineapples (fruits) as protective foods. Over half (51.1%) were overweight/obese. Sources of income and the monthly earnings were significantly associated with the overweight/obesity. Conclusion: The PLWHAs’ sources of income and monthly earnings had statistical significance on their nutritional status (BMI) of being over-weight/obese. However, other factors such as: ART’s ability to decrease resting-energy expenditure and basal metabolic rate resulting in replenishment of muscle bulk and hence weight gain; or intentional over-eating to avoid the stigmatized weight loss which is often “associated” with being HIV positive may have had a part to play. Keywords: PLWHA; ART; Nutritional status (BMI); food groups and consumption; food availability, affordability and use
