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HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries. BMC Public Health 2021 06 12;21(1):1122

Date

06/14/2021

Pubmed ID

34118912

Pubmed Central ID

PMC8196536

DOI

10.1186/s12889-021-11218-5

Scopus ID

2-s2.0-85107763304

Abstract

BACKGROUND: Investigate the relationship between two common cardiovascular diseases and HIV in adults living in sub-Saharan Africa using population data provided through the Demographic and Health Survey.

METHODS: Data for four sub-Saharan countries were used. All adults asked questions regarding diagnosis of HIV, diabetes, and hypertension were included in the sample totaling 5356 in Lesotho, 3294 in Namibia, 9917 in Senegal, and 1051 in South Africa. Logistic models were run for each country separately, with self-reported diabetes as the first outcome and self-reported hypertension as the second outcome and HIV status as the primary independent variable. Models were adjusted for age, gender, rural/urban residence and BMI. Complex survey design allowed weighting to the population.

RESULTS: Prevalence of self-reported diabetes ranged from 3.8% in Namibia to 0.5% in Senegal. Prevalence of self-reported hypertension ranged from 22.9% in Namibia to 0.6% in Senegal. In unadjusted models, individuals with HIV in Lesotho were 2 times more likely to have self-reported diabetes (OR = 2.01, 95% CI 1.08-3.73), however the relationship lost significance after adjustment. Individuals with HIV were less likely to have self-reported diabetes after adjustment in Namibia (OR = 0.29, 95% CI 0.12-0.72) and less likely to have self-reported hypertension after adjustment in Lesotho (OR = 0.63, 95% CI 0.47-0.83). Relationships were not significant for Senegal or South Africa.

DISCUSSION: HIV did not serve as a risk factor for self-reported cardiovascular disease in sub-Saharan Africa during the years included in this study. However, given the growing prevalence of diabetes and hypertension in the region, and the high prevalence of undiagnosed cardiovascular disease, it will be important to continue to track and monitor cardiovascular disease at the population level and in individuals with and without HIV.

CONCLUSIONS: The odds of self-reported diabetes in individuals with HIV was high in Lesotho and low in Namibia, while the odds of self-reported hypertension in individuals with HIV was low across all 4 countries included in this study. Programs are needed to target individuals that need to manage multiple diseases at once and should consider increasing access to cardiovascular disease management programs for older adults, individuals with high BMI, women, and those living in urban settings.

Author List

Egede LE, Walker RJ, Monroe P, Williams JS, Campbell JA, Dawson AZ

Authors

Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Aprill Z. Dawson PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Africa, Northern
Aged
Cardiovascular Diseases
Female
HIV Infections
Humans
Lesotho
Namibia
Prevalence
Senegal
South Africa