Patterns and Risk Factors of HIV and Non-Communicable Disease Co-Morbidity in Urban Tanzania-Exploring the Potential for Family-Based Interventions

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PROJECT SUMMARY/ABSTRACT Non-communicable diseases (NCDs), including diabetes and hypertension, are becoming grave emerging health threats in sub-Saharan Africa, especially among people living with HIV. The health of people living with NCDs and HIV could be significantly improved through interventions encouraging behavioral lifestyle changes, and family-based interventions to enact such change show exciting promise. However, little research has been conducted on these conditions and on interventions to address them in sub-Saharan Africa. In contrast, HIV has been extensively researched and has become a chronic condition in these settings. Due to the existing, well-developed infrastructure of HIV-related services and the commonalities in providing long-term care for HIV and NCDs, developing interventions that integrate screening and care for non-communicable diseases with HIV care is needed. However, more needs to be understood on the prevalence and risk factors of these conditions prior to developing an effective, feasible intervention. Therefore, this mixed methods study seeks to (1) establish the prevalence and risk factors of diabetes and hypertension among people receiving HIV-related care in urban Tanzania and (2) understand families’ knowledge, beliefs, and actions relating to diabetes and hypertension and how this can lead to implementing a family-centered intervention to improve health for this population. To realize these objectives, we propose screening 364 clients receiving HIV-related care for diabetes and hypertension and conducting further assessments with a sub-set of clients’ families. Within 40 families, we will conduct home-based screening for diabetes and hypertension for all adult family members. These families will also be interviewed to assess their understanding of diabetes and hypertension, how the family environment contributes to NCD risks, and how the family can be used to increase support and decrease NCD risks for people living with HIV. Results from this study will be used to develop and test a relevant, culturally-appropriate family-based intervention to improve patient health outcomes for HIV and NCDs.