Title

Self-reported noncommunicable disease prevalence among older people living with HIV in Southern Africa

Presenter

Christine West

Authors

C. West¹, A. Ater¹, S. Hong², B. Nkomo³, F. Asiimwe⁴, T. Tarumbiswa⁵, A. Maida⁶, B. Wilson⁷, O. Mugurungi⁸, K. Stafford⁹, S. Farley¹⁰, E. Agyemang¹, R. Laws¹, I. Rolle¹, A. Voetsch¹

Institutions

¹U.S. Center for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, United States, ²U.S. Center for Disease Control and Prevention, Division of Global HIV and TB, Gaborone, Botswana, ³Ministry of Health, Gaborone, Botswana, ⁴U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Maseru, Lesotho, ⁵Ministry of Health, Maseru, Lesotho, ⁶U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Lilongwe, Malawi, ⁷Ministry of Health, Lilongwe, Malawi, ⁸Ministry of Health, Harare, Zimbabwe, ⁹University of Maryland, Baltimore, United States, ¹⁰ICAP at Columbia University, New York, United States

BACKGROUND: The increasing burden of noncommunicable disease (NCD) among older people living with HIV (OPLWH), and impact of long-term antiretroviral therapy is a concern in low-and middle-income countries (LMIC). However, population-level data describing NCDs and management of comorbidities among PLWH in high HIV burden, LMIC is lacking. The goal of these analyses was to describe the self-reported prevalence of, and current medication use for, NCDs among OPLWH.
METHODS: We used data from population-based HIV-focused household surveys in Botswana, Lesotho, Malawi, and Zimbabwe conducted between 2019-2021. Participants were tested for HIV using the national rapid test algorithms and asked if they ever were told by a doctor or health worker that they had: diabetes mellitus, hypertension, heart disease, renal disease, cancer, lung disease, or mental health conditions. Country sample sizes analyzed ranged from 2,464 to 3,691. Analyses were restricted to those 50 years and older with an HIV+ test result. All estimates were weighted.
RESULTS: The most common NCD reported was hypertension (17.4%), followed by diabetes (3.8%). Overall, OPLWH in Lesotho and Botswana reported higher proportions of hypertension than Malawi and Zimbabwe [Figure]. Of those reporting ever having the condition, 70.6% reported taking medication for hypertension and 64.4% reported taking medication for diabetes across all four countries. More women than men reported currently taking medication for hypertension and diabetes. A low proportion (<2%) of individuals reported heart disease, kidney disease, cancer, lung disease, or mental health conditions.

CONCLUSIONS: The self-reported prevalence of hypertension and diabetes among OPLWH was higher than other NCDs, with lower treatment reported among men. The percentages of NCDs are based on self-report and may not represent the true prevalence of NCDs among OPLWH in these countries. Strengthening NCD surveillance as well as improving access and uptake of NCD-related services overall and as part of HIV service delivery is needed for OPLWH.

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