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Research
Epidemiology of Non-communicable Diseases and Risk factors in South African Adolescents and Youth Living with HIV: Implications for Integrated Prevention
Monika Kamkuemah
University of Cape Town School of Public Health and Family Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7603-2792
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Adolescents and youth living with HIV (AYLHIV) face an elevated NCD risk resulting from HIV, psychosocial challenges and the complications of antiretroviral therapy (ART).
Methods
We conducted a cross-sectional study in six primary care facilities to investigate the prevalence of common NCDs and risk factors among AYLHIV in Cape Town, South Africa between March 2019 and January 2020. We collected information on pre-existent and previously unidentified NCDs and risk factors and collected sociodemographic information of adolescents and youth enrolled for primary HIV care. Characteristics between sexes and age groups were compared using parametric or non-parametric statistical tests.
Results
Three out of four participants were female, and the median age was 20.5 years (IQR 18.9–22.9). More than a quarter were not in education, employment or training (NEET) and 44% were multidimensionally poor. Our results show an existent burden of hypertension (5%) and central obesity (37%) as well as high levels of depression (43%) and psychological distress symptoms (44%). AYLHIV further self-reported high levels of household food insecurity (70%), low fruit and vegetable consumption, high fast-food and sugar-sweetened beverage intake, low nutritional knowledge and insufficient physical activity. Beyond the NCD risk attributable to HIV and ART, these multiple risk factors coupled with early initiation of high-risk behaviours like smoking, alcohol and drug use, further increase risk.
Conclusions
Our findings highlight the importance of integrated prevention with NCD risk screening as part of HIV care for AYLHIV and the need for early intervention on social, environmental and economic determinants of NCDs targeting adolescents and youth.
Keywords
Adolescents, HIV, Non-communicable diseases, Mental health, Risk factors, Prevention, Epidemiology, Multimorbidity
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On 05 Nov, 2020
Review #2 received
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Invitations sent on 04 Nov, 2020
Reviewer #1 agreed
On 04 Nov, 2020
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On 14 Sep, 2020
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This preprint is under consideration at AIDS Research and Therapy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Epidemiology of Non-communicable Diseases and Risk factors in South African Adolescents and Youth Living with HIV: Implications for Integrated Prevention
Monika Kamkuemah
University of Cape Town School of Public Health and Family Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7603-2792
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 22 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 24 Nov, 2020
Review #1 received
Received 21 Nov, 2020
Reviewer #2 agreed
On 05 Nov, 2020
Review #2 received
Received 05 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Reviewer #1 agreed
On 04 Nov, 2020
Editor assigned
On 15 Sep, 2020
Submission checks complete
On 14 Sep, 2020
Editor invited
On 14 Sep, 2020
First submitted
On 10 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Adolescents and youth living with HIV (AYLHIV) face an elevated NCD risk resulting from HIV, psychosocial challenges and the complications of antiretroviral therapy (ART).
Methods
We conducted a cross-sectional study in six primary care facilities to investigate the prevalence of common NCDs and risk factors among AYLHIV in Cape Town, South Africa between March 2019 and January 2020. We collected information on pre-existent and previously unidentified NCDs and risk factors and collected sociodemographic information of adolescents and youth enrolled for primary HIV care. Characteristics between sexes and age groups were compared using parametric or non-parametric statistical tests.
Results
Three out of four participants were female, and the median age was 20.5 years (IQR 18.9–22.9). More than a quarter were not in education, employment or training (NEET) and 44% were multidimensionally poor. Our results show an existent burden of hypertension (5%) and central obesity (37%) as well as high levels of depression (43%) and psychological distress symptoms (44%). AYLHIV further self-reported high levels of household food insecurity (70%), low fruit and vegetable consumption, high fast-food and sugar-sweetened beverage intake, low nutritional knowledge and insufficient physical activity. Beyond the NCD risk attributable to HIV and ART, these multiple risk factors coupled with early initiation of high-risk behaviours like smoking, alcohol and drug use, further increase risk.
Conclusions
Our findings highlight the importance of integrated prevention with NCD risk screening as part of HIV care for AYLHIV and the need for early intervention on social, environmental and economic determinants of NCDs targeting adolescents and youth.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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Figure 7