Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa.
S Afr Med J. 2022 Apr 4;112(4):259-267.
Adolescents and youth living with HIV (AYLHIV) face an elevated non-communicable disease (NCD) risk resulting from HIV, psychosocial challenges, and the complications of antiretroviral therapy.
To investigate the prevalence of common NCDs and their risk factors among AYLHIV in urban Cape Town, South Africa, in order to inform an integrated approach to NCD screening and prevention in AYLHIV.
We conducted a cross-sectional study in six primary care facilities in Cape Town between March 2019 and January 2020. We collected sociodemographic information, and assessed dietary intake, physical activity and nutritional knowledge. We also screened for pre-existing and previously unidentified NCDs and modifiable risk factors in 92 adolescents and youth receiving treatment for HIV in primary care settings using self-report and objective measures. Differences between sexes and age groups were compared using parametric and non-parametric statistical tests.
Three out of four participants were female, and the median (interquartile range) age was 20.5 (18.9 - 22.9) years. More than a quarter were not in education, employment or training, and 44% were multidimensionally poor. Five percent of participants had measured hypertension, and 37% had central obesity. AYLHIV self-reported high levels of household food insecurity (70%), low daily fruit and vegetable consumption (28% and 52%, respectively), high refined sugar and sugar-sweetened beverage intake (31% and 29% daily intake, respectively), regularly skipping breakfast (42%), low nutritional knowledge (37% average score) and insufficient weekly physical activity levels (31%). A third (30%) were current smokers, and 24% engaged in binge drinking.
Our findings of a high prevalence of NCDs and risk factors in AYLHIV highlight the importance of NCD risk screening as part of HIV care for AYLHIV. Such integrated approaches are needed to achieve the dual purpose of improving outcomes through early diagnosis of pre-existing NCDs as well as the prevention of NCD multimorbidity in AYLHIV. This study further demonstrates the need for early intervention on the social, environmental and economic determinants of NCDs targeting adolescents and youth.
艾滋病毒感染者青少年和青年（AYLHIV）面临着因 HIV、心理社会挑战以及抗逆转录病毒治疗的并发症而导致的非传染性疾病（NCD）风险升高。
调查南非开普敦城市中 AYLHIV 常见 NCD 及其危险因素的流行情况，为 AYLHIV 中 NCD 筛查和预防的综合方法提供信息。
我们于 2019 年 3 月至 2020 年 1 月在开普敦的六家初级保健机构进行了一项横断面研究。我们收集了社会人口统计学信息，并评估了饮食摄入、身体活动和营养知识。我们还使用自我报告和客观测量方法，在接受初级保健机构 HIV 治疗的 92 名青少年和青年中筛查了现有的和以前未识别的 NCD 以及可改变的危险因素。使用参数和非参数统计检验比较了性别和年龄组之间的差异。
四分之三的参与者为女性，中位数（四分位距）年龄为 20.5（18.9-22.9）岁。超过四分之一的人没有接受教育、就业或培训，44%的人多维贫困。5%的参与者患有高血压，37%的人患有中心性肥胖。AYLHIV 自我报告家庭食物不安全程度高（70%），每日水果和蔬菜摄入量低（分别为 28%和 52%），精制糖和含糖饮料摄入量高（分别为每日 31%和 29%），经常不吃早餐（42%），营养知识水平低（平均得分为 37%），每周身体活动水平不足（31%）。三分之一（30%）的人是当前吸烟者，24%的人酗酒。
我们发现 AYLHIV 中 NCD 及其危险因素的高患病率强调了将 NCD 风险筛查作为 AYLHIV HIV 护理的一部分的重要性。这种综合方法需要实现双重目的，即通过早期诊断现有的 NCD 来改善结果，并预防 AYLHIV 中的 NCD 多种疾病。本研究进一步证明，需要针对青少年和青年的 NCD 的社会、环境和经济决定因素进行早期干预。
