Abstract A055: Adapting a nutrition education and counseling intervention for diet-related cancer prevention in low-resource HIV care settings: A case study from Uganda

Abstract People living with HIV (PLWH) face increased diet-related cancer risks, driven in part by poor diet quality, including low intake of fruits and vegetables (F/V). Nutrition Education and Counseling (NEAC) interventions are low-cost strategies shown to improve diet-related behaviors and have the potential to increase F/V intake, improve diet quality, and lower cancer risk in this population. Despite their effectiveness, NEAC remains underutilized in resource-limited settings where HIV and poor diet quality co-exist. This study aims to explore barriers and facilitators to implementing an NEAC intervention in an HIV care setting in a low-resource context. We conducted a qualitative study using individual interviews (IDIs) to explore multilevel contextual factors affecting dietary choices and food access among PLWH, as well as the transfer of nutrition knowledge to patients at HIV clinics. Findings aimed to inform the adaptation of a 12-session NEAC intervention over 8 months. Interview guides were informed by implementation science frameworks, including the Consolidated Framework for Implementation Research and the Theoretical Domains Framework, and the socio-ecological model. IDIs were conducted with both health care providers and PLWH enrolled in the APHS Cohort Study in Wakiso district in Uganda between December 2024 and June 2025. Data were analyzed using abductive coding and rapid qualitative analysis to identify key themes. A total of (n=9) providers and (n=18) PLWH from three HIV clinics participated. PLHW ranged in age from 21 to 56 years; 39% (n=7) were male; 33% (n=6) resided in rural areas, 22% (n=4) in urban areas, and 44% (n=8) in semi-urban areas. Providers included Clinicians (n=5), Counselors (n=4). IDIs with PLWH highlighted the need for specific cancer related nutrition knowledge, unexplored user preferences related to intervention delivery mode (e.g., length/frequency of intervention activities), a significant interest in increasing consumption of F/V, and diverse needs related to food access. PLWH and providers exhibited extensive HIV-nutrition related knowledge and a high-level of understanding of the role nutrition plays in disease prevention. However, IDIs with providers revealed limited resources to share knowledge with patients and a limited ability to follow up with patients expressing interest in nutrition services. Only one clinic reported providing nutrition support or counseling to HIV patients. Both providers and PLWH identified NEAC intervention sessions that prioritize individual counseling, safeguard HIV status confidentiality, and deliver knowledge and practical skills in food budgeting, cooking, and making better food choices as highly acceptable and desirable. These findings will inform adaptations to the core components of the NEAC intervention, increasing its feasibility and delivery success in HUV care settings. Ultimately, improved implementation of NEAC interventions may increase diet quality, reduce cancer risk and improve the health and survival of PLWH in low-resource settings. Citation Format: Gloria Guevara Alvarez, Resty Nakajugo, Specy Mwima, Jonah Nyanzi, Emmanuel Menya, Alex Daama, Yesim Tozan, Donna Shelley. Adapting a nutrition education and counseling intervention for diet-related cancer prevention in low-resource HIV care settings: A case study from Uganda [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A055.