INTEGRATED NCDs TREATMENT AND CARE AMONG PEOPLE LIVING WITH HIV/AIDS ATTENDING CARE AND TREATMENT AT A HEALTH FACILITY

Abstract

Introduction Persons living with HIV (PLHIV) in Tanzania now live longer due to the advancement of HIV care programs. For this reason, they are at an increased risk of developing Non-Communicable Diseases (NCDs). Despite many resources committed to HIV care programs, NCDs care is not effectively integrated into these programs. The study aimed at describing missed opportunities to diagnose and manage hypertension and diabetes and implementing and evaluating the effect of three months of preventive efforts among among PLHIV attending care and treatment centers (CTC) Materials and methods We evaluated 333 PLHIV attending CTC for blood pressure and blood sugar levels. Patients who were diagnosed with high blood pressure equal to or above 140/90 mm Hg, or on treatment for hypertension and a fasting blood sugar above 7.0 mmol/L (126 mg/dl) were subjected to a small intervention aimed at increasing health literacy on the adherence to and control of their pathologies. Re-evaluation of their blood pressure and blood sugar levels was done at the end of a 3 months intervention. Results Of the evaluated 333 PLHIV, 71 (21.32%) had hypertension and 9 (2.70%) had high blood sugar. Among 177 PLHIV who never had their BP measured before, 37/177 ((20.90%) were diagnosed with hypertension. The cohort group involved analysis of 76 patients with either uncontrolled hypertension or diabetes followed for three months. By the end of the 3rd month of intervention, 26/71 (36.6%) were able to control their blood pressure (BP < 140 SBP and < 90 DBP). The mean blood pressure decreased from 164/99.5 mmHg to 159 /96mmHg. Of the 9 PLHIV with high blood glucose levels, 5/9 (55.5%) had their blood sugar normalized at the end of the intervention. In a focused group discussion, most patients reported difficulties in controlling their BP due to the high cost of medication and consequently poor adherence to medication. Conclusion The burden of undiagnosed NCDs among PLHIV attending care and treatment clinic is remarkably high. Interventions to address such diseases in CTC seem to work. HIV care and treatment programs should provide integrated care that includes NCDs care.