Abstract
BackgroundType2 Diabetes and Hypertension (T2DM/HTN) have become serious threats to the health and socio-economic development in the developing countries. People living with HIV (PLHIV) infection are more vulnerable of developing T2DM/HTN due to HIV infection itself and antiretroviral treatments. The situation is worse when behavioral and biological risk factors are pervasive to PLHIV. Despite this vicious circle; information on the level of knowledge and perception regarding prevention of T2DM/HTN, risks factors and associated complications among PLHIV is not well documented in Tanzania. The aim of this paper was assess the level of T2DM/HTN knowledge and perception among PLHIV and utilizing care and treatment clinic (CTC) services.MethodsA cross-sectional study was conducted in randomly selected 12 CTCs between October 2011 and February 2012. Data on demographic characteristics, type 2 diabetes and hypertension knowledge and perception were collected from the study participants.ResultsOut of 754 PLHIV and receiving HIV services at the selected CTCs, 671 (89%) consented for the study. Overall 276/671(41.1%) respondents had low knowledge on type2 diabetes and hypertension risk factors and their associated complications. Locality (rural) (AOR = 2.2; 95%CI 1.4–3.4) and never/not recalling if ever measured blood glucose in life (AOR = 2.3; 95%CI 1.1–5.7) were significant determinants of low knowledge among clients on ART. Being currently not having HIV and T2DM/HTN co-morbidities (AOR = 2.2; 95%CI 1.2–4.9) was the only determinant of low knowledge among ART Naïve clients. With regard to perception, 293/671(43.7%) respondents had negative perception on diabetes and hypertension prevention. Sex (female) (AOR = 2.0, 95%CI 1.2–2.9), being aged < 40 years (AOR = 1.6; 95%CI 1.1–2.5) and education (primary/no formal education) (AOR = 4.4; 95%CI 2.0–9.8) were determinants for negative perception among clients on ART while for ART Naïve clients; HIV and T2DM/HTN co-morbidities (AOR = 2.0; 95%CI 1.2–4.6) was the main determinant for negative perception.ConclusionConsiderable number of respondents had low level of knowledge (41.1%) regarding T2DM/HTN specifically on the risk factors, prevention strategies and their associated complications and negative perception (43.7%) towards healthy practices for mitigating risk behaviors of the diseases. There is need for promoting awareness of T2DM/HTN risk factors and complications by considering determinants of low knowledge and negative perception among PLHIV.
Highlights
Type2 Diabetes and Hypertension (T2DM/HTN) have become serious threats to the health and socio-economic development in the developing countries
The linkage between T2DM/HTN and Human Immunodeficiency Virus (HIV) are because HIV itself has been associated with the damage of blood vessels cells and causing atherosclerosis [7, 8]
People living with HIV (PLHIV) who are on Antiretroviral Treatment (ART) have been reported to be at high risk of developing type2 diabetes and hypertension, probably due to: cumulative exposure to ART [9,10,11], increased risks of cholesterol and fatty acid imbalance which are associated with dyslipidemia and metabolic syndrome [3, 12,13,14,15]
Summary
Type Diabetes and Hypertension (T2DM/HTN) have become serious threats to the health and socio-economic development in the developing countries. The situation is worse when behavioral and biological risk factors are pervasive to PLHIV Despite this vicious circle; information on the level of knowledge and perception regarding prevention of T2DM/HTN, risks factors and associated complications among PLHIV is not well documented in Tanzania. Apart from socio-economic impacts; HIV has been associated with the risk of developing type diabetes and hypertension (T2DM/HTN) [2,3,4,5,6]. Despite improved life expectancy; ART including nucleotide reverse transcriptase Inhibitors (NRTIs) and stavudine based regimens have been reported to increase the risk of raised blood levels of lipid profile (triglycerides, low density lipoprotein cholesterol and total cholesterol) as well as lowering high density lipoprotein [17, 18] which are the risk factors for developing T2DM/ HTN. HIV/AIDS, ART and aging among PLHIV have been consistently reported to be associated with renal related morbidity and mortality [21, 22] and type diabetes [9,10,11]
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