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The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa

Manne-Goehler, J; Montana, L; Gomez-Olive, FX; Rohr, J; Harling, G; Wagner, RG; Wade, A; ... Gaziano, TA; + view all (2017) The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa. JAIDS Journal of Acquired Immune Deficiency Syndromes , 75 (5) pp. 561-567. 10.1097/QAI.0000000000001445. Green open access

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Abstract

The prevalence of diabetes and hypertension has increased in HIV-positive populations, but there is limited understanding of the role that antiretroviral therapy (ART) programs play in the delivery of services for these conditions. The aim of this study is to assess the relationship between ART use and utilization of health care services for diabetes and hypertension.Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa is a cohort of 5059 adults. The baseline study collects biomarker-based data on HIV, ART, diabetes, and hypertension and self-reported data on health care utilization. We calculated differences in care utilization for diabetes and hypertension by HIV and ART status and used multivariable logistic regressions to estimate the relationship between ART use and utilization of services for these conditions, controlling for age, sex, body mass index, education, and household wealth quintile.Mean age, body mass index, hypertension, and diabetes prevalence were lower in the HIV-positive population (all P < 0.001). Multivariable logistic regression showed that ART use was significantly associated with greater odds of blood pressure measurement [adjusted odds ratio (aOR) 1.27, 95% confidence interval (CI): 1.04 to 1.55] and blood sugar measurement (aOR 1.26, 95% CI: 1.05 to 1.51), counseling regarding exercise (aOR 1.57, 95% CI: 1.11 to 2.22), awareness of hypertension diagnosis (aOR 1.52, 95% CI: 1.12 to 2.05), and treatment for hypertension (aOR 1.63, 95% CI: 1.21 to 2.19).HIV-positive patients who use ART are more likely to have received health care services for diabetes and hypertension. This apparent ART advantage suggests that ART programs may be a vehicle for strengthening health systems for chronic care.

Type: Article
Title: The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAI.0000000000001445
Publisher version: http://dx.doi.org/10.1097/QAI.0000000000001445
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, Art Programs, Non-Communicable Diseases, Health Systems, Middle-Income Countries, Sub-Saharan Africa, Older-Adults, Antiretroviral Therapy, HIV Treatment, Population, Surveillance, Prevalence, Management, Programs
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/1566520
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