Leveraging HIV Programming to Enhance Access to Noncommunicable Disease Care in Southern Botswana.

Abstract

The objective of this study was to assess whether HIV programming in southern Botswana could be leveraged to provide care for patients with noncommunicable diseases (NCDs). A retrospective analysis was performed to determine the spectrum and complexity of NCDs seen by HIV-focused outreach programming delivered between July 2011 and December 2013, to 9 facilities in southern Botswana. The association of HIV status and specific International Classification of Disease codes was examined using bivariate analysis. Outreach HIV physicians recorded 926 outpatient consults involving 835 patients during the studied period. While 25% (n=209) of patients seen were HIV infected, most patients were either HIV negative (49%, n=410) or had an unknown HIV status (26%, n=216). Noncommunicable disease referrals were as common at primary- and district-level facilities (90% [n=459] versus 93% [n=301]; P=.22). This study demonstrates how HIV programming in Botswana can be leveraged to improve access to specialist medical services for patients with NCDs.