Cardiometabolic disease risk and HIV status in rural South Africa: establishing a baseline

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• 作者：Samuel J Clark ; F Xavier Gómez-Olivé ; Brian Houle ; Margaret Thorogood…
• 关键词：South Africa ; Rural ; Cardiometabolic risk ; HIV/AIDS
• 刊名：BMC Public Health
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：369 KB
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• 作者单位：Samuel J Clark (1) (2) (3) (6) (7)
  F Xavier Gómez-Olivé (1) (6)
  Brian Houle (1) (2) (9)
  Margaret Thorogood (1) (3) (8)
  Kerstin Klipstein-Grobusch (3) (4)
  Nicole Angotti (1) (10) (2) (3)
  Chodziwadziwa Kabudula (1) (6)
  Jill Williams (2) (3)
  Jane Menken (2) (3)
  Stephen Tollman (1) (3) (5) (6)
  
  1. MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  2. Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
  3. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  6. INDEPTH Network, Accra, Ghana
  7. Department of Sociology, University of Washington, Seattle, USA
  9. Australian Demographic and Social Research Institute, Australian National University, Canberra, Australia
  8. Division of Health Sciences, University of Warwick Medical School, Coventry, UK
  4. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
  10. Department of Sociology and Center on Health, Risk, and Society, American University, Washington, DC, USA
  5. Centre for Global Health Research, Ume? University, Ume?, Sweden
  
• 刊物主题：Public Health; Medicine/Public Health, general; Epidemiology; Environmental Health; Biostatistics; Vaccine;
• 出版者：BioMed Central
• ISSN：1471-2458

文摘

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 2010-011 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 17-1) 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.