The mean BMI was 19.5kg/m2 for male which is almost similar with the general Ethiopian male population of mean BMI of 19kg/m2, but the mean BMI of 17 for female in this study is lower than the general Ethiopian women population of mean BMI 20 [20]. This might be due to the fact that HIV is common in women than the men. It is straightforward 17-AAG solubility to appreciate the proportion of malnutrition in the majorly affected segment of the population. The higher risk of developing malnutrition in unemployed subjects found in this study is agreed with other study [4] where unemployment promotes poverty, which in turn limits the ability of individual to expend money for food consumption. The less likelihood of developing malnutrition among respondents in the moderate economic status implies improved income level insures food security at household level.

As it is confirmed by findings from previous study in Ethiopia, food insecurity is a significant problem for PLWHAs with low household income [21]. The implication is improving household income and creating employment opportunities for PLWHAs might be among the tenets of comprehensive continuum of care. Independent of all other variables, WHO clinical stage four has significant effect on the likelihood of malnutrition development. Malnutrition is usually encountered at the advanced phase or end of the HIV infection course [18]. An anthropometric measurement like BMI is lower in symptomatic patients classified by WHO stages [22].

Similarly, study from Uganda showed HIV positive persons in WHO clinical stage four often characterized by sever wasting (chronic fever, chronic diarrhea and weight loss greater than 10% from base line), and food aid to PLHIV delayed HIV disease progression [23]. Further research with longitudinal design recommended seeing the effect of malnutrition on HIV infection progression since nutritional status could modulate the immunological responses to HIV infection over time [24]. Consistent with other findings [2,25,26] this study has proven the statistical significance of the association between gastrointestinal symptoms (GIS) and malnutrition among PLHIV. As it has been discussed elsewhere in this article, HIV infection affects nutritional status by reducing dietary intake & nutrient absorption. It affects the nutritional status by increasing nutrient absorption as a result of the increased demand or utilization of protein, excretion of protein and other micronutrients [8,22,23].

Batimastat Similar to this study and references cited elsewhere have shown that patients with GIS like chronic diarrhea, vomiting and loss of appetite found to be significantly threatening the nutritional status of PLWHAs [1,22]. This study did not assess the effect of each opportunistic infection on the nutritional status of the study subjects. Nevertheless, it has been learnt that the number of previous opportunistic infections were independent risk factors of malnutrition.