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HIV/AIDS
Original research
Demographics and health profile on precursors of non-communicable diseases in adults testing for HIV in Soweto, South Africa: a cross-sectional study
  1. Kathryn L Hopkins1,2,
  2. Khuthadzo Hlongwane1,
  3. Kennedy Otwombe1,
  4. Janan Dietrich1,3,
  5. Mireille Cheyip4,
  6. Nompumelelo Khanyile4,
  7. Tanya Doherty2,3,
  8. Glenda E Gray1,5
  1. 1Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Soweto, South Africa
  2. 2School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  3. 3Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
  4. 4Centers for Disease Control and Prevention, Pretoria, South Africa
  5. 5Office of the President, South African Medical Research Council, Cape Town, South Africa
  1. Correspondence to Kathryn L Hopkins; HopkinsK{at}phru.co.za

Abstract

Objectives This cross-sectional study investigated the burden of HIV-non-communicable disease (NCD) precursor comorbidity by age and sex. Policies stress integrated HIV-NCD screenings; however, NCD screening is poorly implemented in South African HIV testing services (HTS).

Setting Walk-in HTS Centre in Soweto, South Africa.

Participants 325 voluntary adults, aged 18+ years, who provided written or verbal informed consent (with impartial witness) for screening procedures were enrolled.

Primary and secondary outcomes Data on sociodemographics, tuberculosis and sexually transmitted infection symptoms, blood pressure (BP) (≥140/90=elevated) and body mass index (<18.5 underweight; 18.5–25.0 normal; >25 overweight/obese) were stratified by age-group, sex and HIV status.

Results Of the 325 participants, the largest proportions were female (51.1%; n=166/325), single (71.5%; n=231/323) and 25–34 years (33.8%; n=110/325). Overall, 20.9% (n=68/325) were HIV infected, 27.5% (n=89/324) had high BP and 33.5% (n=109/325) were overweight/obese. Among HIV-infected participants, 20.6% (14/68) had high BP and 30.9% (21/68) were overweight/obese, as compared with 29.3% (75/256) and 12.1% (31/256) of the HIV-uninfected participants, respectively. Females were more likely HIV-infected compared with males (26.5% (44/166) vs 15.1% (24/159); p=0.012). In both HIV-infected and uninfected groups, high BP was most prevalent in those aged 35–44 years (25% (6/24) vs 36% (25/70); p=0.3353) and >44 years (29% (4/14) vs 48% (26/54); p=0.1886). Males had higher BP than females (32.9% (52/158) vs 22.3% (37/166); p=0.0323); more females were overweight/obese relative to males (45.8% (76/166) vs 20.8% (33/159); p<0.0001). Females were more likely to be HIV infected and overweight/obese.

Conclusion Among HTS clients, NCD precursors rates and co-morbidities were high. Elevated BP occurred more in older participants. Targeted integrated interventions for HIV-infected females and HIV-infected people aged 18–24 and 35–44 years could improve HIV public health outcomes. Additional studies on whether integrated HTS will improve the uptake of NCD treatment and improve health outcomes are required.

  • public health
  • hypertension
  • international health services
  • epidemiology
  • HIV and AIDS

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-030701

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    Footnotes

    • Contributors KLH conceptualised the study and manuscript and was the primary author. KLH, KH, KO and JD analysed and interpreted the data. MC and NK were technical advisors of the study and provided review of the manuscript. GG and TD provided conceptual contributions and review of the manuscript. All authors read and approved the final manuscript.

    • Funding The study was supported by the Cooperative Agreement to the Medical Research Council (MRC) ofSouth Africa for Tuberculosis Control and HIV Prevention, Care, and Treatment Activities under thePresident’s Emergency Plan for AIDS Relief (PEPFAR) (Funding Opportunity Number: CDC-RFA-GH13-1340; Cooperative Agreement Number: 1U2GPS001150).

    • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The health programme was approved by the University of Witwatersrand, Human Research Ethics Committee. The approval number is 170 307.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.