scholarly journals Prevalence of Overweight And Obesity And Associated Factors Among People Living With Hiv Attending A Tertiary Care Clinic In Uganda

Author(s):  
Esther Alice Nalugga ◽  
Eva Laker ◽  
Maria Sarah Nabaggala ◽  
Ahmed Ddungu ◽  
Charles Batte ◽  
...  

Abstract Background: Overweight and obesity are significantly increasing among people living with HIV (PLWH), contributing to the risk of major adverse cardio-metabolic events. However, little is known on its prevalence among PLWH in sub-Saharan Africa. In this study, we report the prevalence and factors associated with overweight and obesity among PLWH in a large tertiary HIV clinic in Kampala, Uganda. Methods: A cross-sectional, retrospective review of electronic database of all PLWH that attended the Adult Infectious Diseases Institute clinic between November 2018 and April 2019 was conducted. Demographic, body mass index (BMI) [kg/m2] and clinical variables were extracted. Based on BMI, nutritional status was classified as undernutrition (< 18.5kg/m2), normal (≥18.5 < 25kg/m2), overweight (≥25 < 30kg/m2) and obesity (≥ 30kg/m2). Poisson regression analysis was performed to determine factors associated with overweight and obesity.Results: Overall, 7,818 participants were included in the analysis, 64% (n=4,976) were female, with a median age of 44 years (interquartile range (IQR): 36 — 51) and a median BMI of 24.2 (IQR: 21.2 — 28.1). The prevalence of overweight and obesity combined was 46% (55% female versus 30% male), obesity 18.2% (24.6% female versus 7.1% male) and overweight 27.8% (30.4% female versus 22.9% male). Factors associated with overweight and obesity were: Female sex (adjusted prevalence ratio [aPR]: 1. 8, 95%CI:1.69 — 1.87), age category 25—59 years (aPR: 1.9, 95%CI: 1.63 — 2.24) and ≥ 60 years (aPR: 1.8, 95%CI:1.49 — 2.12); duration on antiretroviral therapy (ART) for 6—10 years (aPR: 1.1, 95%CI:1.08 — 1.18), CD4 count ≥500 (aPR:1.3, 95%CI:1.21 — 1.30) and having at least one noncommunicable disease (NCD) (aPR: 1.1, 95%CI:1.07 — 1.18). Conclusions: There is a high burden of overweight and obesity among PLWH in Uganda. Nutrition and weight management programs particularly targeting high risk groups such as female and persons with underlying NCDs should be integrated into HIV care.

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S462-S463
Author(s):  
Daniel Sack ◽  
Ariano Matino ◽  
Graves Erin ◽  
Almiro Emilio ◽  
Bryan Shepherd ◽  
...  

Abstract Background Depression contributes to HIV treatment outcomes in sub-Saharan Africa, where approximately 15% of people living with HIV have comorbid depression. HoPS+, a cluster randomized trial among seroconcordant couples living with HIV, assesses male partner involvement during antenatal HIV care and HIV outcomes. We describe predictors of depressive symptoms among pregnant partners living with HIV in Zambézia Province, Mozambique. Methods This baseline cross-sectional analysis includes 1079 female HoPS+ participants. We show demographic (age, enrollment date, relationship status, education, and occupation) and clinical (WHO HIV stage, body mass index [BMI], and antiretroviral therapy [ART] use history) factors. We model females’ depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]) using proportional odds models with continuous covariates as restricted cubic splines (enrollment date, age, BMI, partner’s PHQ-9 score), categorical covariates (district, relationship status, education, occupation, WHO stage), and ART use history. Missing covariates were imputed 20 times. Results Participants’ median age was 23 (interquartile range [IQR] 20-28). Most women reported no or &lt; 7 years of education (84.1%), were farmers (61.3%), and were WHO stage I (81.9%). They had a median PHQ-9 score of 3 (IQR 0-5) and 47 (43.6%) had moderately severe or severe depressive symptoms, with 19.6% missing PHQ-9 scores. Among 867 pregnant partners with PHQ-9s, demographic and clinical covariates were not meaningful predictors of PHQ-9 score. Male partner’s PHQ-9 score, however, was associated with (covariate-adjusted Spearman’s rho 0.58, 95% Confidence Interval [CI]: 0.51-0.65) and strongly predictive of a pregnant partner’s score (Figure). An increase in a male partner’s PHQ-9 score from 9 to 10 was associated with 1.47 times increased odds (95% CI: 1.37-1.58) of a ≥1-point increase in a woman’s PHQ-9 score Figure: Female Partner's Depressive Symptoms Conclusion Depressive symptoms are highly correlated among pregnant people and their partners, which may have implications for pregnancy care. Interventions aimed to reduce depressive symptoms and improve HIV-related outcomes during pregnancy may have greater success when focused on addressing both partners’ depressive symptoms. Disclosures All Authors: No reported disclosures


10.2196/13741 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13741
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  

Background The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. Objective The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. Methods A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. Results A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01). Conclusions The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.


2019 ◽  
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  

BACKGROUND The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. OBJECTIVE The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. METHODS A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. RESULTS A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; <italic>P</italic>&lt;.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; <italic>P</italic>=.01). CONCLUSIONS The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e042029
Author(s):  
Moges Baye ◽  
Berihu Fisseha ◽  
Mulugeta Bayisa ◽  
Solomon Mekonnen Abebe ◽  
Balamurugan Janakiraman

ObjectiveThis study aimed to determine the prevalence of fatigue and the factors associated among adult people living with HIV attending antiretroviral therapy clinic in Gondar town, Ethiopia.DesignCross-sectional.SettingGovernmental health facility that provides HIV care in Gondar town.Outcome measureFatigue is defined by nine items version Fatigue Severity Scale.ParticipantsAdult (aged 18 and above) people living with HIV in Gondar town (n=392).ResultA total of 408 HIV seropositive adults were approached for consent, among which 392 participants consented to participate in this study, with a response rate of 96.1%. The mean age of the participants was 40.5±8.5 years. The prevalence of HIV-related fatigue was 53.3% and about 66% of women living with HIV experienced fatigue. The factors associated with fatigue experience were; female gender (adjusted OR (AOR): 2.61, 95% CI 1.01 to 5.3), being married (AOR: 0.18, 95% CI 0.10 to 0.9), low income (AOR: 7.1, 95% CI 4.6 to 22.15), unemployed (AOR: 2.79, 95% CI 1.19 to 9.84), parity (AOR: 4.87, 95% CI 2.18 to 17.9), being anaemic (AOR: 12.45, 95% CI 5.6 to 41.01), depression (AOR: 4.51, 95% CI 1.91 to 11.20), mild weight loss (AOR: 4.2 95% CI 2.56 to 13.9) and moderate weight loss (AOR: 5.1, 95% CI 1.85 to 16.12), respectively.ConclusionThe findings of this study revealed that experiencing fatigue is quite common among adult people living with HIV. It is important for the healthcare professionals and people living with HIV to understand; the possible causes of fatigue, remedies and ways to reclaim energy. The predisposing factors and complications that cause fatigue should be aggressively diagnosed and treated by the clinicians. Further qualitative studies exploring the reasons for experiencing HIV-related fatigue might help designing interventions.


2020 ◽  
Vol 31 (12) ◽  
pp. 1195-1201
Author(s):  
Thana Khawcharoenporn ◽  
Vitsaroot Tanslaruk

Polypharmacy poses risks associated with drug-drug interactions, increased adverse effects, pill burden, poor compliance and unfavorable treatment outcomes. Whether polypharmacy affects treatment outcomes among people living with HIV (PLHIV) is largely unknown. A prospective study was conducted among PLHIV followed-up at a tertiary-care clinic of an academic medical center during January 2012 to December 2017. The clinic provided comprehensive HIV care with multidisciplinary team approach focusing on treatment adherence. Polypharmacy was defined as concurrent use of 5 or more non-antiretroviral (ARV) drugs for at least one year. Of the 248 PLHIV included, 23 (9%) received polypharmacy. PLHIV with polypharmacy were older (median age 45 vs. 36 years), were more likely to have underlying diseases (65% vs. 18%) and had lower median initial CD4 counts (40 vs. 214 cells/mm3). The rates of virologic suppression at 12 months after ARV therapy were 96% and 92% in polypharmacy and non-polypharmacy groups, respectively (P = 0.70), while the median CD4 cell count increase was higher among the non-polypharmacy group at 12 months (207 vs. 403 cells/mm3; P < 0.001). There were no differences in rates of adverse effects and experienced drug-drug interactions. Hospitalization due to HIV-related diseases within 12 months after ARV initiation [adjusted odds ratio (aOR) 11.63, P = 0.004] and lower 3-item score for ARV adherence (aOR 0.49, P = 0.01) were independently associated with failure of virologic suppression at 12 months. These findings suggest that polypharmacy did not affect the virological outcomes among our PLHIV. Patients with the characteristics associated with virological failure should be closely monitored.


Author(s):  
Dharma N. Bhatta ◽  
Jennifer Hecht ◽  
Shelley N. Facente

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.


2017 ◽  
Vol 11 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Idongesit Godwin Utuk ◽  
Kayode Omoniyi Osungbade ◽  
Taiwo Akinyode Obembe ◽  
David Ayobami Adewole ◽  
Victoria Oluwabunmi Oladoyin

Background:Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace.Methods:The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals.Results:Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 – 3.83)].Conclusion:Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.


2013 ◽  
Vol 16 (2) ◽  
pp. 432-443 ◽  
Author(s):  
Joanna d’Arc Lyra Batista ◽  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Demócrito de Barros Miranda-Filho ◽  
Heloisa Ramos Lacerda de Melo ◽  
...  

Introduction: Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. Objective: To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. Methods: A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. Results: The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. Conclusions: It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ketema Bizuwork Gebremedhin ◽  
Tadesse Bedada Haye

Background. Globally, anemia, among people living with HIV/AIDS, is a major public health problem. It has a significant effect on the progression of HIV/AIDS to advanced stages and there are a number of factors that often affect anemia. However, there is little insight regarding factors affecting anemia among HIV/AIDS patients in developing countries, including Ethiopia. Objective. This study aimed at investigating factors affecting anemia among people living with HIV/AIDS taking ART drug at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A hospital based cross-sectional study design was used to assess factors affecting anemia among people living with HIV/AIDS. Structured checklist was used to gather information from charts of patients selected by simple random sampling method. We analyzed the data to identify factors associated with anemia among people with HIV/AIDS using logistic regression models. Results. A total of 301 selected charts were reviewed. The median age was 38 ± 10.38. The majority (62.5%) of the patients were taking ZDV-containing ART drug (ZDV/3TC/NVP). The overall anemia prevalence was 34.6%, while about 5%, 15.6%, and 14% of the patients had severe, moderate, and mild prevalence of anemia, respectively. Factors that were found to affect anemia among these patients include gender (OR = 2.26 [95% CI: 1.22, 4.16]), occupation (OR: 0.57 [95%CI: 0.35, 0.92]), WBC count (OR = 2.30 [95% CI: 1.29, 4.09]), platelet count (OR = 2.89 [95% CI: 0.99, 8.41]), nutritional status (OR = 2.05 [95% CI: 0.69, 6.02]), and WHO clinical stage of HIV/AIDS (OR = 3.69 [95% CI: 1.86, 7.31]). Conclusions. About one in three patients was found to be anemic. Intervention aimed at diagnosing and treating anemia among people living with HIV/AIDS should be considered.


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