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believe that self-reported episodes of serious sickness Data availability statement
within a month are less likely to vary significantly from Due to the private nature of the data, data for the study will be
the actual episodes.
• Adherence to ART use in this study was not assessed, but available only upon request and approval of Authorising
rather assumed, based on satisfactory HIV viral load Ministry of Health.
measurements of participants. There is a possibility that
the observed health experiences measured in this study Disclaimer
might not have been sorely because of inability to The views and opinions expressed in this article are those of
purchase NCD medication alone, but because of
interaction with non-compliance to NCD prescribed the authors and do not necessarily reflect the official policy or
medication or use of traditional medication for NCDs position of any affiliated agency of the authors.
that was common among cases in this study.
• Survival was not assessed in this study to compare References
survival rates between cases and controls. Whilst the 1. Joint United Nations Programme on HIV/AIDS (UNAIDS). Global report: UNAIDS
6-month follow-up was adequate to assess trends in health report on the global AIDS epidemic 2010. Geneva: UNAIDS; 2010.
expenses and health experiences, it was not long enough 2. Harris TG, Rabkin M, El-Sadr WM. Achieving the fourth 90: Healthy aging for
for survival analysis to be performed. Survival analysis people living with HIV. AIDS. 2018;32(12):1563. https://doi.org/10.1097/QAD.
0000000000001870
would have required longer a follow-up period of 5–15 3. Narayan KV, Miotti PG, Anand NP, et al. HIV and noncommunicable disease
years, which would not have been feasible for this study. comorbidities in the era of antiretroviral therapy: A vital agenda for research in
• Representativeness of our research data to other African low-and middle-income country settings. AIDS. 2014;67:S2–S7. https://doi.
org/10.1097/QAI.0000000000000267
countries with stable economies might be limited, in part, 4. Negin J, Mills EJ, Bärnighausen T. Aging with HIV in Africa: The challenges of living
because of the economic crisis faced by Zimbabwe, which longer. AIDS. 2012;26(01):S1. https://doi.org/10.1097/QAD.0b013e3283560f54
makes it unique in sub-Saharan Africa. 5. Nugent R, Barnabas RV, Golovaty I, et al. Costs and cost-effectiveness of HIV/NCD
integration in Africa: From theory to practice. AIDS. 2018;32(Suppl 1):S83. https://
doi.org/10.1097/QAD.0000000000001884
Conclusion 6. Shade SB, Osmand T, Luo A, et al. Cost of integrating non-communicable disease
(NCD) care into Ugandan HIV/medical clinics in the SEARCH study. 9th International
HIV-NCD comorbidity causes an additional burden to PLWH AIDS Society (IAS) Conference 23–26 July 2017; Paris, France: IAS. 2017
because of increased transport costs, NCD prescribed 7. WHO. Working group on the inclusion of NCDs in other programmatic areas:
World Health Organization global coordination mechanism on the prevention and
medication expenses and more productive days lost because control of noncommunicable diseases. Working group 3.1 (2016-2017). Geneva:
of illness. Access to antihypertensives and diabetic World Health Organization; 2018.
medications is influenced by interplay of the key determinants 8. Haregu TN, Oldenburg B, Sestwe G, Elliott J, Nanayakkara V. Epidemiology of
comorbidity of HIV/AIDS and non-communicable diseases in developing countries:
of health, which include income, gender, age and geographical A systematic review. J Glob Health Care Syst. 2012;2(1):1–2.
location. The success of HIV programmes does not only rely 9. Zimbabwe. The National Health Strategy for Zimbabwe, 2009-2013: Equity and
on improving access to the diagnosis and treatment of HIV. quality in health: A people’s right. Harare: Ministry of Health & Child Welfare;
2009.
Addressing the complications of HIV-related NCDs and the 10. WHO. Closing the gap in a generation: Health equity through action on the social
long-term costs of ART and its occasional potential for harm determinants of health: WHO commission on social determinants of health final
report. Geneva: World Health Organization; 2008.
will be essential if health outcomes in Zimbabweans living 11. Türmen T. Gender and HIV/AIDS. Int J Gynaecol Obstet. 2003;82(3):411–418.
with HIV are to be optimised. https://doi.org/10.1016/S0020-7292(03)00202-9
12. Peacock D, Stemple L, Sawires S, Coates TJ. Men, HIV/AIDS, and human rights.
Acknowledgements J Acquir Immune Defic Syndr. 2009;51(Suppl 3):S119–S125. https://doi.org/
10.1097/QAI.0b013e3181aafd8a
The authors acknowledge the support received from the 13. Camlin CS, Ssemmondo E, Chamie G, et al. Men ‘missing’ from population-based
HIV testing: Insights from qualitative research. AIDS Care. 2016;28(Suppl 3):
University of KwaZulu-Natal in conducting the study. 67–73. https://doi.org/10.1080/09540121.2016.1164806
14. Dworkin SL. Who is epidemiologically fathomable in the HIV/AIDS epidemic?.
Gender, sexuality, and intersectionality in public health. Cult Health Sex.
Competing interests 2005;7(6):615–623. https://doi.org/10.1080/13691050500100385
15. Guariguata L, de Beer I, Hough R, et al. Diabetes, HIV and other health determinants
The authors have declared that no competing interest exists. associated with absenteeism among formal sector workers in Namibia. BMC
Public Health. 2012;12(1):44. https://doi.org/10.1186/1471-2458-12-44
16. Piette JD, Heisler M, Wagner TH. Problems paying out-of-pocket medication costs
Authors’ contributions among older adults with diabetes. Diabetes Care. 2004;27(2):384–391.https://
doi.org/10.2337/diacare.27.2.384
All authors contributed equally to this work. 17. Maciel RA, Klück HM, Durand M, Sprinz E. Comorbidity is more common and
occurs earlier in persons living with HIV than in HIV-uninfected matched controls,
aged 50 years and older: A cross-sectional study. Int J Infect Dis. 2018;70:30–35.
Funding information https://doi.org/10.1016/j.ijid.2018.02.009
18. Peltzer K, Pengpid S. Utilization and practice of traditional/complementary/
The study was funded by University of KwaZulu-Natal, alternative medicine (T/CAM) in Southeast Asian nations (ASEAN) member states.
under PhD research grants. Stud Ethno-Med. 2015;9(2):209–218. https://doi.org/10.1080/09735070.2015.1
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