
Increasing Access to HIV Prevention, Care and Treatment Services for Key Popul...
- Central Region, Uganda
The human immunodeficiency virus (HIV) is one of the most dangerous communicable diseases in the world. It is an infection associated with serious diseases. Non-communicable diseases (NCDs) are diseases without an infectious cause. They include cancers, heart disease, lung disease and diabetes etc and they are now the biggest
cause of death worldwide and their burden is expected to rise dramatically over the next 20 years in low- and middle-income countries hence a call for greater action against NCDs.
NCDs are becoming a growing problem in people with HIV as they live longer on successful antiretroviral treatment. Some antiretroviral drugs may increase the risk of heart disease and diabetes, while HIV itself increases the risk of some cancers. NCDs develop in people with HIV because they are living longer on effective treatment.
Many NCDs are diseases that increase in frequency as people age. They may be present before HIV infection, and could be made worse by HIV and by some antiretroviral drugs, so there is a need to incorporate management of other chronic conditions into HIV care.
NCDs need to be addressed both by care and prevention. Measures to reduce smoking, salt and alcohol intake, together with promotion of exercise and weight loss, and treatment of risk factors for heart disease, are agreed to be the priorities for prevention. Our research suggests that NCD prevention and care need to be integrated into HIV care.
Opportunities could include regular screening for high blood pressure, nutritional advice on how to reduce salt and alcohol intake, measurement of blood sugar levels, checking liver and renal function at least once a year, and screening for cervical cancer.
GRONET on HIV treatment and care has much to teach the rest of the health sector about how to develop and sustain high-quality care for people who will need long-term care for a chronic condition. We have many tools and protocols that could be shared with other disease areas, perhaps allowing eventual integration of services.