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Self-reported cardiovascular disease risk factor screening among people living with HIV vs. members of the general
Onkabetse Julia Molefe-Baikai1, Kago Kebotsamang2, Pinkie Modisawakgomo3
1Faculty of Medicine, Department of Internal Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana. onkabetsebaikai@gmail.com.
Insights
People living with HIV (PLWH) are nearly twice as likely to be screened for cardiovascular disease risk factors (CVDRFs) compared to HIV-uninfected individuals. This highlights the need to expand CVD screening and prevention for the general population.
Area of Science:
- Public Health
- Epidemiology
- Cardiology
Background:
- Cardiovascular diseases (CVDs) pose a significant and growing health burden, particularly in low- and middle-income countries.
- People living with HIV (PLWH) face a higher risk of developing CVD compared to the general population.
Purpose of the Study:
- To investigate whether people living with HIV (PLWH) are more likely to have been previously screened for cardiovascular disease risk factors (CVDRFs) than individuals without HIV.
Main Methods:
- A cross-sectional study was conducted in Botswana involving 3981 participants aged 16-68 years.
- Data on screening and counseling for CVDRFs (hypertension, diabetes, cholesterol, weight, smoking, alcohol, physical activity) in the past 3 years were collected.
- Logistic regression analysis was used to compare CVDRF screening rates between PLWH and HIV-uninfected individuals, controlling for age and sex.
Main Results:
- PLWH reported higher rates of screening for diabetes (25% vs. 19%), elevated cholesterol (17% vs. 12%), and weight checks (76% vs. 55%) compared to HIV-uninfected participants.
- PLWH also received more counseling on smoking cessation, weight control, physical activity, and alcohol consumption.
- Overall, PLWH were 1.84 times more likely to have been screened for or counseled on CVDRFs (aOR 1.84, 95% CI: 1.46-2.32).
Conclusions:
- People living with HIV (PLWH) are significantly more likely to be screened for cardiovascular disease risk factors (CVDRFs) than HIV-uninfected individuals.
- The findings underscore the necessity for widespread implementation of integrated CVD management and prevention strategies for the entire population, including those without HIV.
Background:
Morbidity and mortality due to cardiovascular diseases (CVDs) are high and increasing in low- and middle-income countries. People living with HIV (PLWH) are more likely to experience CVD than members of the general population. Therefore, we aimed to assess whether PLWH were more likely to have previously been screened for cardiovascular disease risk factors (CVDRFs) than people without HIV.
Methods:
A population-based, cross-sectional study was conducted among individuals aged 16 to 68 years across 22 communities in Botswana from February to August 2017 as part of a larger community-based cluster randomized HIV treatment-as-prevention trial. Participants were asked if they had been screened for and counselled on cardiovascular disease risk factors (history of hypertension or blood pressure check, blood glucose and cholesterol measurements, weight check and weight control, tobacco smoking and cessation, alcohol use and physical activity) in the preceding 3 years. HIV testing was offered to those with an unknown HIV status. Multiple logistic regression analysis controlling for age and sex was used to assess the relationship between CVDRF screening and HIV status.
Results:
Of the 3981 participants enrolled, 2547 (64%) were female, and 1196 (30%) were PLWH (93% already on antiretroviral therapy [ART]). PLWH were more likely to report previous screening for diabetes (25% vs. 19%, p < 0.001), elevated cholesterol (17% vs. 12%, p < 0.001) and to have had their weight checked (76% vs. 55%, p < 0.001) than HIV-uninfected participants. PLWH were also more likely to have received counselling on salt intake (42% vs. 33%, p < 0.001), smoking cessation (66% vs. 46%, p < 0.001), weight control (38% vs. 29%, p < 0.001), physical activity (46% vs. 34%, p < 0.001) and alcohol consumption (35% vs. 23%, p < 0.001) than their HIV-uninfected counterparts. Overall, PLWH were more likely to have received screening for and/or counselling on CVDRFs (adjusted odds ratio 1.84, 95% CI: 1.46-2.32, p < 0.001).
Conclusion:
PLWH were almost two times more likely to have been previously screened for CVDRFs than those without HIV, indicating a need for universal scale-up of integrated management and prevention of CVDs in the HIV-uninfected population.
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