Burden and determinants of self-reported non-communicable disease comorbidities among HIV positive adults in Tanzania: insights from the Tanzania HIV Impact Survey 2022–2023
Charles Basil Kafaiya, Hillary R Sebukoto, Angelina M Lutambi, Gibson B Kagaruki, Johnson Jeremia Mshiu, Paul M Hayuma, Gerald P Mwing’a, Irene R Mremi, Jonathan M Mshana, Prince Mutalemwa, Sia E Malekia, Kunda J Stephen, Mary T MayigeIntroduction
People living with HIV (PLWH) face an increased risk of developing comorbidities involving HIV and non-communicable diseases (NCDs) caused by a mix of modifiable and non-modifiable risk factors. This study aimed to quantify the burden of NCD-HIV comorbidities and examine their determinants among HIV-positive adults aged ≥15 years using data from the 2022–2023 Tanzania HIV Impact Survey (THIS).
Methods
The 2022–2023 THIS enrolled 33 663 individuals who underwent HIV testing, of whom 1850 tested positive. Key variables, including socioeconomic, demographic and behavioural risk factors and clinical characteristics, were extracted from the main survey database. These variables were modelled as potential determinants of HIV–NCD comorbidities. HIV–NCD comorbidity was defined as being HIV-positive and having at least one non-communicable disease. χ² tests and logistic regression analyses were performed to identify the determinants of HIV–NCD comorbidity.
Results
Among the 1850 PLWH included in the analysis, 70.2% were female, 63.0% resided in rural areas and 70.0% had attained primary education. Hypertension was the most prevalent chronic condition (3.3%), followed by lung disease (1.1%), cancer/tumour (1.0%) and heart disease (1.0%), respectively. The overall prevalence of HIV–NCD comorbidity was 6.7% (95% CI 5.4% to 8.3%). Female participants had significantly higher odds of HIV–NCD comorbidity (adjusted OR (aOR)=1.9; 95% CI 1.2 to 3.1; p=0.010). Age was also strongly linked to comorbidity, with individuals aged 45–54 years (aOR=9.4; 95% CI 2.7 to 33.4; p=0.001) and those aged ≥55 years (aOR=16.1; 95% CI 4.4 to 58.3; p<0.001) showing higher odds than those aged 15–24 years.
Conclusions
HIV–NCD comorbidities are common among PLWH. Female sex and older age significantly increase the risk, emphasising the importance of tailored interventions for prevention, early detection and integrated care strategies.