Page 315 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 7 Original Research

Capacity of antiretroviral therapy sites for managing

NCDs in people living with HIV in Zimbabwe

Authors: Background: There are marked inconsistencies in prevalence data for human immunodeficiency
Laston Gonah virus and non-communicable disease (HIV-NCD) comorbidity in Zimbabwe.
1
Indres Moodley 1
Khumbulani Hlongwana 1 Objectives: To explain these discrepancies, we investigated the capacity of antiretroviral
therapy (ART) sites in managing hypertension (HTN) and diabetes mellitus (DM) in people
Affiliation:
1 Health Outcomes Research living with HIV (PLWH) in Gweru district, Zimbabwe.
Unit, Discipline of Public
Health Medicine, School of Method: This was a qualitative research design in which key informant interviews were
Nursing and Public Health, conducted with eight health managers, and 12 focus group discussions (FGDs) were conducted
College of Health Sciences, with 72 PLWH concurrently diagnosed with HTN and/or DM. Thematic data analysis was
University of KwaZulu-Natal, performed in NVivo version 12®.
Durban, South Africa
Results: Routine screening for HTN and targeted screening for DM were often interrupted by
Corresponding author: dysfunctional machines and intermittent supply of necessary consumables, impacting
Laston Gonah,
[email protected] negatively on the capacity of the sites to monitor and screen for the NCDs. Erratic hypertensive
and diabetic medication availability at study sites were also reported, forcing patients to turn
Dates: to other treatment options (medication rationing or overdose or sharing, use of home remedies
Received: 11 June 2020 and traditional medicines, and reliance on faith and traditional healers).
Accepted: 06 July 2020
Published: 04 Sept. 2020
Conclusion: Findings demonstrate that the quality of observed incidence and prevalence
How to cite this article: data for HTN and DM in LMICs is a function of the capacity of health centres to screen for
Gonah L, Moodley I, NCDs. Given the ageing population of PLWH in sub-Saharan Africa, coupled with increasing
Hlongwana K. Capacity of trends in the prevalence of NCDs in HIV-infected people, HIV programmes have not evolved
antiretroviral therapy sites with the changing needs of PLWH. Attention to the holistic management of PLWH is long
for managing NCDs in people
living with HIV in Zimbabwe. overdue.
S Afr J HIV Med. 2020;21(1), Keywords: hypertension; diabetes mellitus; HIV-NCD comorbidity; NCD management
a1113. https://doi.
org/10.4102/sajhivmed. protocols; NCD screening and treatment.
v21i1.1113
Copyright: Introduction
© 2020. The Authors.
Licensee: AOSIS. This work is Unprecedented global improvement in enabling access to antiretroviral therapy (ART) by people
licensed under the Creative living with human immunodeficiency virus (PLWH), contributing to increased viral suppression
Commons Attribution
1
License. and increased survival in PLWH, is well documented. By the end of 2018, more than 61% of the
37.9 million PLWH, globally, were accessing ART, which is a substantial increase from 45% in
2010. Over the same period, acquired immunodeficiency syndrome (AIDS)-related deaths
1
decreased by about 45%, thereby demonstrating the significant contribution of ART to increased
1
survival in PLWH.
While there is empirical evidence showing the positive contribution of ART to improved survival
in PLWH, new threats associated with non-communicable diseases (NCDs) co-existing with
2
human immunodeficiency virus (HIV) in PLWH have emerged. This co-existence is likely to
impact negatively on the gains already achieved in controlling HIV, especially in many low- to
middle-income countries (LMICs) where the majority of PLWH on ART live and where health
2
care systems are known to be fragile. The real effects of NCDs co-existence with HIV in PLWH in
many settings may be undermined by the lack of accurate data to understand this phenomenon
Read online: fully. For example, there are marked inconsistencies in the Zimbabwean prevalence data for HIV-
Read online:
Scan this QR
Scan this QR NCD comorbidity. 3,4,5 These epidemiological discrepancies can be best explained by studying the
code with your capacity of ART sites to manage NCDs in PLWH, that is, the screening, diagnosis, treatment and
code with your
smart phone or
smart phone or
mobile device data management. Limited capacity to screen and diagnose diseases or conditions may
mobile device
to read online.
to read online.
compromise the quality of the prevalence data generated.
http://www.sajhivmed.org.za 307 Open Access