Abstract
Proper nutrition is essential for women with HIV during pregnancy; however, information on how to access nutritious diets is scarce. This study, informed by the socio-ecological perspectives, examines the barriers to obtaining a healthy diet among pregnant women living with HIV in the Njombe region of Tanzania. A qualitative study employing the ethnography method using semi-structured and narrative interviews to gather information from key informant interviews, indepth interviews and focus group discussions engaged a diverse range of stakeholders. The analysis was done by MAXQDA software employing qualitative content analysis. Further, the thematic analysis was carried out by assigning data into relevant codes to generate categories based on study objectives. The study found inadequate nutritional knowledge among individuals and some healthcare providers in the Njombe region. Poor emotional and physical support from spouses and family members caused pregnant women living with HIV to shoulder an excessive household workload, leading to exhaustion and stress, which hindered their ability to practice healthy dietary behaviors. The level of alcohol consumption was high, posing a risk to their health and well-being. The study identified significant barriers at the individual, community, environmental, and organizational levels that prevent pregnant women living with HIV in the Njombe region of Tanzania from accessing healthy diets. Elevating nutritional awareness within these communities is essential for improving the knowledge, skills, and motivation of pregnant women, their partners, and the wider community to embrace healthy and nutritious dietary practices. While various obstacles to healthy diets may exist, motivation and intentionality in pursuing those dietary choices are equally important. Even in the face of challenges, individuals with a strong understanding of nutrition are more likely to discover alternative strategies to maintain healthy diets.