Association between HIV and Prevalent Hypertension and Diabetes Mellitus in South Africa: Analysis of a Nationally Representative Cross-Sectional Survey

Magodoro, Itai M.; Okello, Samson; Dungeni, Mongiwethu; Castle, Alison; Mureyani, Shakespeare; Danaei, Goodarz

doi:10.1016/j.ijid.2022.05.035

Cited by 22 publications

(11 citation statements)

References 48 publications

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“…Similar results were reported by Chang and coworkers in a study conducted in SA (44), in which the authors found a high prevalence of multimorbidity without differences in the likelihood of noncommunicable diseases among persons living with or without HIV. Similarly, a study conducted using the SADHS 2016 found little evidence of association between HIV and increased prevalence of hypertension or diabetes (45). Likewise, a study using data from Demographic and Health surveys conducted in four African countries found no association or negative association between HIV and self-reported hypertension or diabetes in these countries (46).…”

Section: Discussionmentioning

confidence: 99%

Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa

Cuadros

Moreno

Tomita

et al. 2023

Preprint

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BackgroundSeveral low- and middle-income countries are undergoing a rapid epidemiological transition with a rising burden of non-communicable diseases (NCDs). South Africa (SA) is a country with one of the largest HIV epidemics worldwide and a growing burden of NCDs where the collision of these epidemics poses a major public health challenge.MethodsUsing data from a large nationally representative survey, the South Africa Demographic and Health Survey (SADHS 2016), we conducted a geospatial analysis of several diseases including HIV, tuberculosis (TB), cardiovascular, respiratory, and metabolic diseases to identify areas with a high burden of co-morbidity within the country. We explored the spatial structure of each disease and the associations between diseases using different spatial and visual data methodologies. We also assessed the individual-level co-occurrence of HIV and the other diseases included in the analysis.ResultsThe spatial distribution for HIV prevalence showed that this epidemic is most intense in the eastern region of the country, mostly within the Gauteng, Mpumalanga, and Kwazulu-Natal provinces. In contrast, chronic diseases had their highest prevalence rates in the southern region of the country, particularly in the Eastern and Western Cape provinces. Individual-level analyses were consistent with the spatial correlations and found no statistically significant associations between HIV infection and the presence of any NCDs.ConclusionsWe found no evidence of geospatial overlap between the HIV epidemic and NCDs in SA. These results evidence the complex epidemiological landscape of the country, characterized by geographically distinct areas exhibiting different health burdens. The detailed description of the heterogenous prevalence of HIV and NCDs in SA reported in this study could be a useful tool to inform and direct policies to enhance targeted health service delivery according to the local health needs of each community.

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Section: Discussionmentioning

confidence: 99%

Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa

Cuadros

Moreno

Tomita

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Likewise, a study conducted using the SADHS 2016 found little evidence of association between HIVand increased prevalence of hypertension or diabetes. 52 Moreover, a study using data from Demographic and Health surveys conducted in four African countries found no association or negative association between HIV and selfreported hypertension or diabetes in these countries. 53 Lastly, a similar study conducted in Zambia and Western Cape found negative association between HIV-seropositive status and diabetes.…”

Section: Discussionmentioning

confidence: 98%

Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa

Cuadros,

Moreno,

Tomita

et al. 2023

Journal of Multimorbidity and Comorbidity

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Introduction Several low-and middle-income countries are undergoing rapid epidemiological transition with a rising burden of non-communicable diseases (NCDs). South Africa (SA) is a country with one of the largest HIV epidemics worldwide and a growing burden of NCDs where the collision of these epidemics poses a major public health challenge. Methods Using data from a large nationally representative survey, the South Africa Demographic and Health Survey (SADHS 2016), we conducted a geospatial analysis of several diseases including HIV, tuberculosis (TB), cardiovascular, respiratory, and metabolic diseases to identify areas with a high burden of co-morbidity within the country. We explored the spatial structure of each disease and associations between diseases using different spatial and visual data methodologies. We also assessed the individual level co-occurrence of HIV and the other diseases included in the analysis. Results The spatial distribution for HIV prevalence showed that this epidemic is most intense in the eastern region of the country, mostly within the Gauteng, Mpumalanga, and Kwazulu-Natal provinces. In contrast, chronic diseases had their highest prevalence rates the southern region of the country, particularly in the Eastern and Western Cape provinces. Individual-level analyses were consistent with the spatial correlations and found no statistically significant associations between HIV infection and the presence of any NCDs. Conclusions We found no evidence of geospatial overlap between the HIV epidemic and NCDs in SA. These results evidence the complex epidemiological landscape of the country, characterized by geographically distinct areas exhibiting different health burdens. The detailed description of the heterogenous prevalence of HIV and NCDs in SA reported in this study could be a useful tool to inform and direct policies to enhance targeted health service delivery according to the local health needs of each community.

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“…However, caution is needed when applying this narrative in some emerging economy settings. In South Africa, while rates of obesity and metabolic syndrome are high within populations of PWH this may be commensurate with local trends: a recent study identified favourable cardiometabolic risk profiles in PWH compared to controls without HIV, and instead suggested socioeconomic factors as the predominant driver of obesity within this context [23,24 ▪ ].…”

Section: Obesity In People With Hivmentioning

confidence: 99%

Intersections between HIV and obesity in emerging economies

Levi,

Fairhead,

Hill

2023

Current Opinion in HIV and AIDS

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Purpose of review HIV epidemics are increasing in many emerging economy countries, whilst the very process of ‘economic emergence’ is obesogenic. Annual deaths related to obesity and overweight are now four times more than for HIV globally. We describe the intersections between HIV and obesity in emerging economies, and highlight potential mitigation options, including antiobesity medications (AOMs), which are safe and effective, but inaccessibly priced. Recent findings We summarize what is known about weight-change in HIV and review strategies including public health policies and clinical interventions for emerging economy countries to fight obesity. We also illustrate the landscape from a selection of ‘emerging economy’ countries with available data from UNAIDS, World Bank and World Obesity Federation to visualize the developing challenges faced. AOM course prices are high in many countries, but could be manufactured and sold profitably for much less. We present lessons from the early HIV/AIDS movements on how to improve access and pricing for AOMs for people with HIV with obesity in emerging economy countries. Summary We illustrate the complex intersectional issues that ‘emerging economy countries’ may experience, with a ‘double burden’ of increasing HIV and obesity epidemics, and explore potential mitigation options, focussing on AOM access and pricing.

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Association between HIV and Prevalent Hypertension and Diabetes Mellitus in South Africa: Analysis of a Nationally Representative Cross-Sectional Survey

Cited by 22 publications

References 48 publications

Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa

Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa

Geospatial assessment of the convergence of communicable and non-communicable diseases in South Africa

Intersections between HIV and obesity in emerging economies

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