Abstract
BackgroundMany people are now living longer with HIV due to access to antiretroviral treatment. In turn, there has been an increase in the burden of hypertension and diabetes. The paucity of data on the burden of hypertension and diabetes in adults living with HIV in South Africa is a public health concern. The paper aimed to describe the prevalence and factors associated with hypertension and diabetes among adults living with HIV (ALHIV).MethodsThis was a secondary data analysis of the population based on the South African National HIV Prevalence, Incidence, Behaviour and Communication surveys for 2005, 2008 and 2017. Descriptive statistics were used to summarise the characteristics of the study sample. Bivariate and multivariate logistic regression analyses were used to determine factors associated with hypertension and diabetes.ResultsThe total study population of ALHIV aged 25 years and older was 978, 1023 and 2483 for 2005, 2008 and 2017. The prevalence of hypertension showed an increasing trend at 11.8% in 2005, 9.5% in 2008 and 14.3% in 2017. The prevalence of diabetes was 3.3% in 2005, 2.8% in 2008 and 3.2% in 2017. Increased odds of hypertension among adults living with HIV were consistently associated with being female and the age group 45 years older across all the survey years, including pensioners and the sick, living in urban areas, high risk of hazardous alcohol consumption, diabetes and heart disease. Increased odds of diabetes were consistently associated with hypertension across all the survey years, including age group 45 years and older, and poor health. While having a secondary level of education and above was protective against diabetes.ConclusionThe study showed that the prevalence of hypertension is high and has increased over time among adults living with HIV while the prevalence of diabetes has remained constant. Findings identified factors consistently associated with the prevalence of both diseases overtime, including contemporary risk factors that should be targeted in the integrated management of chronic disease and HIV care model.
Highlights
Many people are living longer with Human immunodeficiency virus (HIV) due to access to antiretroviral treatment
This paper investigates trends, prevalence and associated factors of hypertension and diabetes among adults living with HIV (ALHIV) in South Africa using the 2005, 2008, 2012, and 2017 nationally representative population-based HIV Prevalence, Incidence, Behaviour and Communication Surveys
This study found an overall prevalence of hypertension among ALHIV in 2017 of 14.3%, and this was an increase since 2005
Summary
Many people are living longer with HIV due to access to antiretroviral treatment. The successful roll-out of the anti-retroviral therapy (ART) programme since 2004 has contributed to improvements in the life expectancy and viral load suppression in PLHIV; and deaths due to opportunistic infections have declined [3, 4] This has transformed HIV infection into a chronic disease and evidence shows that as a consequence of a combination of factors including ageing, being on ART, HIV infection and certain lifestyle choices, their risk of developing non-communicable diseases (NCDs) including hypertension or diabetes increases [5]. Studies that have been done to characterise the burden of hypertension and diabetes in PLHIV highlight the implication of collecting prevalence estimates and adequately addressing multimorbidity in PLHIV and ensuring adequate availability of treatment to reduce the risk [7]. Further studies indicated that hypertension and diabetes can act as risk factors of each other [12]
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