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Cardiometabolic disease risk and HIV status in rural South Africa : establishing a baseline
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Clark, Samuel J., Gómez-Olivé, F. Xavier, Houle, Brian C, Thorogood, Margaret, Klipstein-Grobusch, Kerstin, Angotti, Nicole, Kabudula, Chodziwadziwa W., Williams, Jill, Menken, Jane and Tollman, Stephen (2015) Cardiometabolic disease risk and HIV status in rural South Africa : establishing a baseline. BMC Public Health, Volume 15 (Number 1). pp. 1-9. doi:10.1186/s12889-015-1467-1 ISSN 1471-2458.
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Official URL: http://dx.doi.org/10.1186/s12889-015-1467-1
Abstract
BackgroundL
To inform health care and training, resource and research priorities, it is essential to establish how non-communicable disease risk factors vary by HIV-status in high HIV burden areas; and whether long-term anti-retroviral therapy (ART) plays a modifying role.
Methods:
As part of a cohort initiation, we conducted a baseline HIV/cardiometabolic risk factor survey in 2010–2011 using an age-sex stratified random sample of ages 15+ in rural South Africa. We modelled cardiometabolic risk factors and their associations by HIV-status and self-reported ART status for ages 18+ using sex-stratified logistic regression models.
Results:
Age-standardised HIV prevalence in women was 26% (95% CI 24-28%) and 19% (95% CI 17–21) in men. People with untreated HIV were less likely to have a high waist circumference in both women (OR 0.67; 95% CI 0.52-0.86) and men (OR 0.42; 95% CI 0.22-0.82). Untreated women were more likely to have low HDL and LDL, and treated women high triglycerides. Cardiometabolic risk factors increased with age except low HDL. The prevalence of hypertension was high (40% in women; 30% in men).
Conclusions:
Sub-Saharan Africa is facing intersecting epidemics of HIV and hypertension. In this setting, around half the adult population require long-term care for at least one of HIV, hypertension or diabetes. Together with the adverse effects that HIV and its treatment have on lipids, this may have serious implications for the South African health care system. Monitoring of the interaction of HIV, ART use, and cardiometabolic disease is needed at both individual and population levels.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
| Library of Congress Subject Headings (LCSH): | Heart -- Diseases -- South Africa, HIV infections -- South Africa | ||||||||
| Journal or Publication Title: | BMC Public Health | ||||||||
| Publisher: | BioMed Central Ltd. | ||||||||
| ISSN: | 1471-2458 | ||||||||
| Official Date: | 12 February 2015 | ||||||||
| Dates: |
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| Volume: | Volume 15 | ||||||||
| Number: | Number 1 | ||||||||
| Number of Pages: | 9 | ||||||||
| Page Range: | pp. 1-9 | ||||||||
| DOI: | 10.1186/s12889-015-1467-1 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 29 December 2015 | ||||||||
| Date of first compliant Open Access: | 29 December 2015 | ||||||||
| Funder: | National Institute on Aging (NIA), United States. National Institute of Child Health and Human Development, Wellcome Trust (London, England), University of the Witwatersrand | ||||||||
| Grant number: | R24AG032112 (NIA), K01 HD057246 (NICHD), R01 HD054511 (NICHD), 058893/Z/99/A (WT), 069683/Z/02/Z (WT), 085477/Z/08/Z (WT) |
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