USDA donates funds for teaching food safety awareness to AIDS patients

Researchers at the University of Illinois at Chicago School of Public Health have received a grant from the U.S. Department of Agriculture to educate AIDS patients on food safety.

The three-year, $600,000 award will be used to develop a better way to disseminate information to AIDS patients who are at high risk of developing infections from the foods they eat.

Nearly half a million people in the United States are living with AIDS, and the number is increasing.

AIDS patients whose immune systems have been severely suppressed by the HIV virus to a T-cell count below 200 cells per microliter are at risk of developing life-threatening infections from food-borne illnesses.

In addition to their compromised immune systems, people with AIDS may have low stomach acid, which is the first barrier against germs, said Dr. Mark Dworkin, UIC associate professor of epidemiology and principal investigator of the study. Stomach acid normally kills most of the germs that enter the body through the mouth. For example, such patients can become infected with salmonella bacteria from eating fresh fruits and vegetables that are not washed properly.

Dworkin said most people with AIDS are probably not aware that food safety recommendations for them may include heating lunch meat. Listeria, a foodborne pathogen that has been attributed to eating lunch meat and soft cheeses, can cause meningitis and sepsis in AIDS patients.

Other risks include:

• Toxoplasmosis, a pathogen transmitted by ingesting raw or partly cooked meat, which can cause encephalitis.
• Cryptosporidiosis, spread through contaminated water and beverages, which causes severe diarrhea that lasts for weeks or months.
• Mycobacterium avium complex (known as MAC), which can cause bacteremia, anemia, fatigue and wasting.

The researchers will interview 300 AIDS patients in Chicago, New Orleans and Bayam-n, Puerto Rico, to determine the biggest knowledge gaps in food safety.

"During the first wave of interviews, we'll ask questions about behavior and risk," said Dworkin. "Do they eat a lot of lunch meat? Do they eat p-t-? Do they cook their own food? Do they go out to eat frequently?"

Using information gathered from those interviews, the researchers will create an entertaining and educational comic book that has the theme of a menu. The book will be disseminated at AIDS clinics in the three cities. Researchers will return a month later to assess patients' knowledge of food safety issues.

Researchers will also survey health care providers in the three cities to determine if they have food safety educational material for AIDS patients and to raise awareness about the new evidenced-based intervention.

Traditional food-borne disease surveillance does not take AIDS into account. It is unknown among the various food-borne outbreaks how many of these illnesses are occurring in AIDS patients.

Dworkin said the greatest risk for disease from food-borne pathogens is likely among the newly diagnosed AIDS patients who are not yet receiving anti-retroviral therapy; those who have resistant virus; and those who have other difficulties with their HIV medication and stay in the low AIDS range.

Dworkin has received two previous grants totaling $1.5 million from the USDA to create evidence-based educational materials for restaurant food handlers in Chicago and the surrounding suburbs.