TY - JOUR
T1 - Cardiometabolic disease risk and HIV status in rural South Africa
T2 - establishing a baseline
AU - Clark, Samuel J.
AU - Gomez-Olive, F. Xavier
AU - Houle, Brian
AU - Thorogood, Margaret
AU - Klipstein-Grobusch, Kerstin
AU - Angotti, Nicole
AU - Kabudula, Chodziwadziwa
AU - Williams, Jill
AU - Menken, Jane
AU - Tollman, Stephen
PY - 2015/2/12
Y1 - 2015/2/12
N2 - Background: 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.
AB - Background: 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.
KW - South Africa
KW - Rural
KW - Cardiometabolic risk
KW - HIV/AIDS
KW - DEMOGRAPHIC SURVEILLANCE SYSTEM
KW - AGINCOURT HEALTH
KW - HYPERTENSION
KW - POPULATION
KW - PREVALENCE
KW - MORTALITY
KW - EPIDEMIC
KW - OLDER
KW - CARE
U2 - 10.1186/s12889-015-1467-1
DO - 10.1186/s12889-015-1467-1
M3 - Article
C2 - 25885455
SN - 1471-2458
VL - 15
JO - BMC Public Health [E]
JF - BMC Public Health [E]
M1 - 15:135
ER -