Abiola-Adepoju V, Abdulrahim A, Jamil S

Language: English
References: 5
Page: 7-8
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The World Health Organization (WHO)’s 2025 human immunodeficiency virus (HIV) service delivery guideline recognizes that the epidemic is entering a new era marked by ageing, multimorbidity, and limited resources.1 Although global Antiretroviral Therapy (ART) coverage now reaches 31.6 million people, only 73% of People living with HIV (PLHIV) achieve viral suppression.2 Increasing life expectancy increases vulnerability to chronic comorbidities. In sub-Saharan Africa, 5-10% of PLHIV have diabetes, and 20-25% have hypertension. A meta-analysis of 10,916 participants across East Africa found hypertension prevalence at 19.75%, with alcohol use, diabetes, and longer HIV duration as key predictors.3 Traditional HIV clinics, structured for infectious disease management, remain poorly equipped for lifelong chronic care. Without addressing hypertension and diabetes, cardiovascular risk will escalate, ultimately threatening viral suppression and the hard-won gains of the HIV response.

REFERENCES

1. World Health Organization. WHO guideline on HIVservice delivery: updated guidance on the integrationof diabetes, hypertension and mental health services,and interventions to support adherence to antiretroviraltherapy. Geneva: World Health Organization; 2025.Available in: https://www.who.int/publications/i/item/9789240113879

2. UNAIDS. Global HIV & AIDS statistics — Fact sheet2024. Geneva: Joint United Nations Programme onHIV/AIDS (UNAIDS); 2025. Available in: https://www.unaids.org/en/resources/fact-sheet

3. Tegegne KD, Adela GA, Kassie GA, Mengstie MA,Seid MA, Zemene MA et al. Prevalence and factorsassociated with hypertension among peoples livingwith HIV in East Africa, a systematic review andmeta-analysis. BMC Infect Dis. 2023; 23 (1): 724. doi:10.1186/s12879-023-08679-x.

4. Bogart LM, Shazi Z, MacCarthy S, Mendoza-Graf A,Wara NJ, Zionts D et al. Implementation of SouthAfrica’s central chronic medicine dispensing anddistribution program for HIV treatment: a qualitativeevaluation. AIDS Behav. 2022; 26 (8): 2600-2612.doi: 10.1007/s10461-022-03602-y.

5. Kivuyo S, Birungi J, Okebe J, Wang D, Ramaiya K, AinanS et al. Integrated management of HIV, diabetes, andhypertension in sub-Saharan Africa (INTE-AFRICA): apragmatic cluster-randomised, controlled trial. Lancet.2023; 402 (10409): 1241-1250. doi: 10.1016/S0140-6736(23)01573-8.