Abstract
People living with HIV (PLWH) on antiretroviral therapy (ART) are living longer and are at risk of HIV co-morbidities including non-communicable diseases (NCDs), particularly in low-resource settings. However, the evidence base for effectively integrating HIV and NCD care is limited. The Chronic Health Care (CHC) checklist, designed to screen for multiple NCDs including a 6-item diabetes self-report screener, was implemented at two PEPFAR-supported HIV clinics in Kabwe and Kitwe, Zambia. Study objectives were to describe the HIV care and treatment population and their self-reported diabetes-related symptoms, and to evaluate provider-initiated screening and referral post-training on the CHC checklist. This cross-sectional study enrolled 435 adults receiving combination ART services. Clinic exit interviews revealed 46% self-reported at least one potential symptom, and 6% self-reported three or more symptoms to the study team, indicating risk for diabetes and need for further diagnostic testing. In comparison, only 8% of all participants reported being appropriately screened for diabetes by their health provider, with less than 1% referred for further testing. This missed opportunity for screening and referral indicates that HIV-NCD integration efforts need more fully resourced and multi-pronged approaches in order to ensure that PLWH who are already accessing ART receive the comprehensive, holistic care they need.
Publisher
Public Library of Science (PLoS)
Reference23 articles.
1. WHO global strategy on integrated people-centred health services 2016–2026. Executive Summary. Placing people and communities at the centre of health services.;WHO,2015
2. Scaling up chronic care systems: leveraging HIV programs to support noncommunicable disease services;M. Rabkin;JAIDS,2011
3. National Responses to HIV/AIDS and Non-Communicable Diseases in Developing Countries: Analysis of Strategic Parallels and Differences;T. N. Haregu;Journal of Public Health Research,2014
4. Non-communicable diseases and HIV care and treatment: models of integrated service delivery.;M. Duffy;Tropical Medicine & International Health: TM & IH,2017
5. Emerging priorities for HIV service delivery;N. Ford;PLoS Medicine,2020