The study aimed to assess the efficacy of therapeutic and supplementary feeding interventions in mitigating malnutrition among HIV-positive adolescents and adults (aged 15 to 59) receiving antiretroviral therapy (ART) in Lesotho. Employing an open cohort design and retrospective 2017 data, a mixed-methods approach combined qualitative and quantitative data collection from hard copy and electronic registers at Senkatana Centre, Maseru. Fifty participants were included: 25 with severe acute malnutrition (SAM) and 25 with moderate acute malnutrition (MAM).

Findings revealed that 15 SAM patients transitioned to the next rehabilitation phase in the MAM programme, while 13 MAM patients achieved successful recovery based on BMI assessment. Healthcare workers often deviated from rehabilitation guidelines due to shortages of essential nutritional commodities, forcing them to improvise with available resources.

Recommendations stressed the need for larger-scale nationwide studies. A dearth of literature on SAM and MAM management in HIV-positive populations is compounded by discrepancies between practices and national guidelines due to resource constraints. This disconnect underscores the potential for misleading results and highlights the need for improved resource allocation and adherence to established protocols.

Findings revealed that SMMEs generally offer employment conditions favourable for promoting treatment adherence among employees on chronic medication. Accessibility to treatment at health facilities and employees’ understanding of their medical conditions were noted as strengths. Formal workplace policies addressing basic conditions of employment, labour relations and HIV and tuberculosis wellness were however found to be inadequate. More than half of the respondents reported difficulties in adhering to medication schedules at work, pointing to challenges in taking medication at the correct time, skipping doses and experiencing medication-related work interference.