Background: Adolescents living with HIV face unique obstacles that negatively influence their dietary practices, including stigmatization, discrimination, medication side effects, mental health concerns, and limited access to healthy food options. Appropriate dietary practices are key for improving immunity, enhancing optimal nutritional status, and maintaining adherence to antiretroviral therapy (ART). Stunting and weight loss are common signs of under nutrition among people living with HIV. Adolescents with infection are especially prone to malnutrition due to increased nutritional demands associated with puberty and HIV infection.

Objective: The study aimed at establishing the dietary practices and the nutrition status of the adolescents attending Kiambu level five hospital, Kiambu county, Kenya.

Design: The research employed a cross-sectional analytical approach using quantitative and qualitative techniques. The purposive sampling was used to select the Kiambu Level 5 Hospital as the study site due to its high reported HIV cases among adolescents at the comprehensive clinic offering adolescents friendly services. A study sample of 271 adolescents was selected to participate in the study using the systematic sampling. Dietary practices data was collected using 24-hour recall, dietary diversity questionnaire and focused group discussions.

Results: Age distribution showed most respondents were between 15-19 years (69.4%) while 30.6% fit within 10-14 years. Participants were comprised of 271 individuals; 51.3% were male and 48.7% female. Energy intake among 271 participants ranged from 571.17 to 2056.01 kcal with a standard deviation intake of 971.15±387.20 kcal. Protein consumption averaged 39.47±15.99 grams on average and ranged between 17.28 grams and 71.45 grams; fat consumption ranged between 4.40 grams to 114.98 grams while fibre intake varied between 7.41 to 34.49 grams on average. The study found out 26.7% had low diversity scores between 0 and 3, 36.8 % had moderate diversity scores between 4 and 5, and 30.6 % experienced high diversity scoring 6 or 12 on their diversity. Adolescents' diets were characterized by inadequate energy intake, particularly among males. Adolescents relied on carbohydrate-rich foods at the expense of protein and essential micronutrients like iron, folic acid, calcium and zinc. Nutritional status assessments revealed that 48% had normal BMI for age while 46.9% were undernourished.

Conclusion: The dietary practices of the adolescents with HIV were poor. Characterized by inadequate energy intake, particularly among males. Adolescents relied on carbohydrate-rich foods at the expense of protein and essential micronutrients like iron, folic acid, calcium and zinc which are crucial components of immunity function and overall health. Also, Nutritional status assessments revealed that 48% had normal BMI for age while 46.9% were undernourished.