Prevalence of Diabetes and Hypertension among People Living With HIV/AIDS (PLWHIV) Attending Isiolo County Referral Hospital Comprehensive Care Clinic, Kenya

People living with HIV/AIDS (PLWHIV) are increasingly experiencing a growing burden of non-communicable diseases, particularly hypertension and diabetes, alongside chronic HIV infection. However, evidence on the prevalence and associated factors of these conditions among PLWHIV in arid and semi-arid regions of Kenya remains limited. This study aimed to determine the prevalence of hypertension and diabetes and examine their socio-demographic and anthropometric correlates among PLWHIV attending the Comprehensive Care Clinic at Isiolo County Referral Hospital, Kenya. A hospital-based cross-sectional analytical study was conducted among 231 HIV-positive adults receiving antiretroviral therapy. Data were collected using a structured interviewer-administered questionnaire and standardized clinical measurements, including blood pressure, fasting blood glucose, weight, and height. Data were analyzed using IBM SPSS Statistics version 25.0 through descriptive statistics and chi-square tests of association. The findings revealed that 42.4% of respondents had previously been diagnosed with hypertension, while 23.4% had previously been diagnosed with diabetes. Clinical assessment further showed that 39.4% of respondents were classified within Stage 1 hypertension and 16.0% within Stage 2 hypertension, while 39.4% were diabetic and 24.2% were pre-diabetic based on fasting blood glucose measurements. Hypertension prevalence was significantly associated with age group, gender, education level, occupation, BMI category, and blood pressure classification (p < 0.05). Similarly, diabetes prevalence demonstrated significant associations with age, gender, education level, occupation, income status, and BMI category (p < 0.05). Older respondents, females, and underweight participants generally exhibited higher prevalence of both conditions. The study concludes that hypertension and diabetes represent a significant cardiometabolic burden among PLWHIV in Isiolo County and highlights the need for integrated HIV-NCD screening and management within Comprehensive Care Clinics in resource-limited settings.

Hypertension, Diabetes, PLWHIV, Prevalence, Comprehensive Care Clinic, Kenya, Non-communicable Diseases, Antiretroviral Therapy

1. Achwoka, D., Mutave, R., Oyugi, J. O., & Achia, T. (2020). Tackling an emerging epidemic: the burden of non-communicable diseases among people living with HIV/AIDS in sub-Saharan Africa. The Pan African Medical Journal, 36, 271. https://doi.org/10.11604/pamj.2020.36.271.22810 [Google Scholar] [Crossref]

2. Achwoka, D., Waruru, A., Chen, T. H., Masamaro, K., Ngugi, E., Kimani, M., ... & De Cock, K. M. (2019). Noncommunicable disease burden among HIV patients in care: a national retrospective longitudinal analysis of HIV-treatment outcomes in Kenya, 2003-2013. BMC public health, 19(1), 372. https://doi.org/10.1186/s12889-019-6716-2 [Google Scholar] [Crossref]

3. Bigna, J. J., & Noubiap, J. J. (2021). Global burden of hypertension in people living with HIV. BMC medicine, 19(1), 112. https://doi.org/10.1186/s12916-021-01981-y [Google Scholar] [Crossref]

4. Bigna, J. J., Ndoadoumgue, A. L., Nansseu, J. R., Tochie, J. N., Nyaga, U. F., Nkeck, J. R., ... & Noubiap, J. J. (2020). Global burden of hypertension among people living with HIV in the era of increased life expectancy: a systematic review and meta-analysis. Journal of Hypertension, 38(9), 1659-1668. | DOI: 10.1097/HJH.0000000000002446 [Google Scholar] [Crossref]

5. Bigna, J. J., Noubiap, J. J., Nansseu, J. R., & Aminde, L. N. (2017). Prevalence and etiologies of pulmonary hypertension in Africa: a systematic review and meta-analysis. BMC pulmonary medicine, 17(1), 183. https://doi.org/10.1186/s12890-017-0549-5 [Google Scholar] [Crossref]

6. Bloomfield, G. S., Khazanie, P., Morris, A., Rabadán-Diehl, C., Benjamin, L. A., Murdoch, D., ... & Hicks, C. (2014). HIV and noncommunicable cardiovascular and pulmonary diseases in low-and middle-income countries in the ART era: what we know and best directions for future research. JAIDS Journal of Acquired Immune Deficiency Syndromes, 67, S40-S53. | DOI: 10.1097/QAI.0000000000000257 [Google Scholar] [Crossref]

7. Currier, J. S., Lundgren, J. D., Carr, A., Klein, D., Sabin, C. A., Sax, P. E., ... & Working Group 2. (2008). Epidemiological evidence for cardiovascular disease in HIV-infected patients and relationship to highly active antiretroviral therapy. Circulation, 118(2), e29-e35. https://doi.org/10.1161/CIRCULATIONAHA.107.189624 [Google Scholar] [Crossref]

8. Dimala, C. A., Atashili, J., Mbuagbaw, J. C., Wilfred, A., & Monekosso, G. L. (2016). A comparison of the diabetes risk score in HIV/AIDS patients on highly active antiretroviral therapy (HAART) and HAART-naïve patients at the Limbe Regional Hospital, Cameroon. PLoS One, 11(5), e0155560. https://doi.org/10.1371/journal.pone.0155560 [Google Scholar] [Crossref]

9. Dubé, M. P., Shen, C., Mather, K. J., Waltz, J., Greenwald, M., & Gupta, S. K. (2010). Relationship of body composition, metabolic status, antiretroviral use, and HIV disease factors to endothelial dysfunction in HIV-infected subjects. AIDS research and human retroviruses, 26(8), 847-854. https://doi.org/10.1089/aid.2010.0007 [Google Scholar] [Crossref]

10. Dushimiyimana, V., Kirunga, Y. M. I., Tuyishime, A., Tuyishime, S., Islam, K. M., Nshimiyimana, L., ... & Callens, S. (2026). Prevalence, correlates of dyslipidaemia, and 10-year cardiovascular risk among people living with HIV and people without HIV adults in Rwanda: insights from the NCOHIRWA cohort study. Lipids in Health and Disease, 25(1), 15. https://doi.org/10.1186/s12944-025-02813-1 [Google Scholar] [Crossref]

11. Ekrikpo, U. E., Kengne, A. P., Bello, A. K., Effa, E. E., Noubiap, J. J., Salako, B. L., ... & Okpechi, I. G. (2018). Chronic kidney disease in the global adult HIV-infected population: a systematic review and meta-analysis. PloS one, 13(4), e0195443. https://doi.org/10.1371/journal.pone.0195443 [Google Scholar] [Crossref]

12. Fincham, J. E. (2008). Response rates and responsiveness for surveys, standards, and the Journal. American journal of pharmaceutical education, 72(2). https://doi.org/10.5688/aj720243 [Google Scholar] [Crossref]

13. Grinspoon, S., & Carr, A. (2005). Cardiovascular risk and body-fat abnormalities in HIV-infected adults. New England Journal of Medicine, 352(1), 48-62. [Google Scholar] [Crossref]

14. Hagstrom, C., Kalande, P., Aryal, A., Phiri, K., Van Oosterhout, J. J., Talama, G., ... & Hoffman, R. (2025). Healthcare provider and health system leader perspectives on barriers to hypertension care in Malawi: insights from integrated and non-integrated HIV care settings. Global Health Action, 18(1), 2575569. https://doi.org/10.1080/16549716.2025.2575569 [Google Scholar] [Crossref]

15. Kagaruki, G. B., Mayige, M. T., Ngadaya, E. S., Kimaro, G. D., Kalinga, A. K., Kilale, A. M., ... & Mfinanga, S. G. (2014). Magnitude and risk factors of non-communicable diseases among people living with HIV in Tanzania: a cross sectional study from Mbeya and Dar es Salaam regions. BMC public health, 14(1), 904. https://doi.org/10.1186/1471-2458-14-904 [Google Scholar] [Crossref]

16. Kalyesubula, R., Kayongo, A., Semitala, F. C., Muhanguzi, A., Katantazi, N., Ayers, D., ... & Mills, E. J. (2016). Trends and level of control of hypertension among adults attending an ambulatory HIV clinic in Kampala, Uganda: a retrospective study. BMJ global health, 1(3). https://doi.org/10.1136/bmjgh-2016-000055 [Google Scholar] [Crossref]

17. Kavishe, B., Biraro, S., Baisley, K., Vanobberghen, F., Kapiga, S., Munderi, P., ... & Grosskurth, H. (2015). High prevalence of hypertension and of risk factors for non-communicable diseases (NCDs): a population based cross-sectional survey of NCDS and HIV infection in Northwestern Tanzania and Southern Uganda. BMC medicine, 13(1), 126. https://doi.org/10.1186/s12916-015-0357-9 [Google Scholar] [Crossref]

18. Kaze, A. D., Schutte, A. E., Erqou, S., Kengne, A. P., & Echouffo-Tcheugui, J. B. (2017). Prevalence of hypertension in older people in Africa: a systematic review and meta-analysis. Journal of hypertension, 35(7), 1345-1352. https://doi.org/10.1097/HJH.0000000000001345 [Google Scholar] [Crossref]

19. Kenya National Bureau of Statistics (KNBS), Ministry of Health (MoH), NACC, KEMRI, & DHS Program. (2015). Kenya STEPwise survey for non-communicable diseases risk factors 2015 report. Ministry of Health. [Google Scholar] [Crossref]

20. Kenya National Bureau of Statistics. (2020). 2019 Kenya population and housing census: Volume IV. KNBS. [Google Scholar] [Crossref]

21. Kintu, A., Sando, D., Okello, S., Mutungi, G., Guwatudde, D., Menzies, N. A., ... & Verguet, S. (2020). Integrating care for non‐communicable diseases into routine HIV services: key considerations for policy design in sub‐Saharan Africa. Journal of the International AIDS Society, 23, e25508. https://doi.org/10.1002/jia2.25508 [Google Scholar] [Crossref]

22. Koethe, J. R., Lagathu, C., Lake, J. E., Domingo, P., Calmy, A., Falutz, J., ... & Capeau, J. (2020). HIV and antiretroviral therapy-related fat alterations. Nature reviews Disease primers, 6(1), 48. [Google Scholar] [Crossref]

23. Magodoro, I. M., Esterhuizen, T. M., & Chivese, T. (2016). A cross-sectional, facility based study of comorbid non-communicable diseases among adults living with HIV infection in Zimbabwe. BMC research notes, 9(1), 379. https://doi.org/10.1186/s13104-016-2187-z [Google Scholar] [Crossref]

24. Manne-Goehler, J., Montana, L., Gómez-Olivé, F. X., Rohr, J., Harling, G., Wagner, R. G., ... & Gaziano, T. A. (2017). The ART advantage: health care utilization for diabetes and hypertension in rural South Africa. JAIDS Journal of Acquired Immune Deficiency Syndromes, 75(5), 561-567. https://doi.org/10.1097/QAI.0000000000001445 [Google Scholar] [Crossref]

25. Mendenhall, E., Kohrt, B. A., Norris, S. A., Ndetei, D., & Prabhakaran, D. (2017). Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. The Lancet, 389(10072), 951-963. [Google Scholar] [Crossref]

26. Ministry of Health (MoH). (2023). Strategic framework for integrated HIV and NCD management. Nairobi: MoH. [Google Scholar] [Crossref]

27. Mohamed, S. F., Mutua, M. K., Wamai, R., Wekesah, F., Haregu, T., Juma, P., ... & Ogola, E. (2018). Prevalence, awareness, treatment and control of hypertension and their determinants: results from a national survey in Kenya. BMC public health, 18(Suppl 3), 1219. https://doi.org/10.1186/s12889-018-6052-y [Google Scholar] [Crossref]

28. Moyo-Chilufya, M., Maluleke, K., Kgarosi, K., Muyoyeta, M., Hongoro, C., & Musekiwa, A. (2023). The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis. EClinicalMedicine, 65. https://doi.org/10.1016/j.eclinm.2023.102255 [Google Scholar] [Crossref]

29. Nansseu, J. R., Bigna, J. J., Kaze, A. D., & Noubiap, J. J. (2018). Incidence and risk factors for prediabetes and diabetes mellitus among HIV-infected adults on antiretroviral therapy: a systematic review and meta-analysis. Epidemiology, 29(3), 431-441. | DOI: 10.1097/EDE.0000000000000815 [Google Scholar] [Crossref]

30. National AIDS and STI Control Programme (NASCOP). (2016). Kenya national guidelines on use of antiretroviral drugs for treating and preventing HIV infection in Kenya (3rd ed.). Ministry of Health. [Google Scholar] [Crossref]

31. Nduka, C. U., Stranges, S., Kimani, P. K., Sarki, A. M., & Uthman, O. A. (2017). Is there sufficient evidence for a causal association between antiretroviral therapy and diabetes in HIV‐infected patients? A meta‐analysis. Diabetes/metabolism research and reviews, 33(6), e2902. https://doi.org/10.1002/dmrr.2902 [Google Scholar] [Crossref]

32. Okoh, E. O. (2025). Prevalence of Non-Communicable Diseases and Risk Factors among Long-Term Survivors of HIV: A Systematic Review. Port Harcourt Journal of Public Health, 1(2). [Google Scholar] [Crossref]

33. Oni, T., McGrath, N., BeLue, R., Roderick, P., Colagiuri, S., May, C. R., & Levitt, N. S. (2014). Chronic diseases and multi-morbidity-a conceptual modification to the WHO ICCC model for countries in health transition. BMC public health, 14(1), 575. https://doi.org/10.1186/1471-2458-14-575 [Google Scholar] [Crossref]

34. Patel, P., Rose, C. E., Collins, P. Y., Nuche-Berenguer, B., Sahasrabuddhe, V. V., Peprah, E., ... & Levitt, N. S. (2018). Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: a systematic review and meta-analysis. Aids, 32, S5-S20. | DOI: 10.1097/QAD.0000000000001888 [Google Scholar] [Crossref]

35. Peck, R. N., Shedafa, R., Kalluvya, S., Downs, J. A., Todd, J., Suthanthiran, M., & Kataraihya, J. B. (2014). Hypertension, kidney disease, HIV and antiretroviral therapy among Tanzanian adults: A cross-sectional study. BMC Medicine, 12(1), 125. | DOI: 10.1097/QAD.0000000000001888 [Google Scholar] [Crossref]

36. Semu, H., Zack, R. M., Liu, E., Hertzmark, E., Spiegelman, D., Sztam, K., ... & Fawzi, W. (2016). Prevalence and risk factors for overweight and obesity among HIV-infected adults in Dar es Salaam, Tanzania. Journal of the International Association of Providers of AIDS Care (JIAPAC), 15(6), 512-521. https://doi.org/10.1177/2325957414542574 [Google Scholar] [Crossref]

37. Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian journal of dermatology, 61(3), 261-264. | DOI: 10.4103/0019-5154.182410 [Google Scholar] [Crossref]

38. Todowede, O. O., Mianda, S. Z., & Sartorius, B. (2019). Prevalence of metabolic syndrome among HIV-positive and HIV-negative populations in sub-Saharan Africa—a systematic review and meta-analysis. Systematic reviews, 8(1), 4. https://doi.org/10.1186/s13643-018-0927- [Google Scholar] [Crossref]

39. Triant, V. A. (2014). Epidemiology of coronary heart disease in HIV patients. Reviews in cardiovascular medicine, 15(0 1), S1. https://doi.org/10.3908/ricm15S1S002 [Google Scholar] [Crossref]

40. Vorster, H. H., Kruger, A., Wentzel-Viljoen, E., Kruger, H. S., & Margetts, B. M. (2014). Added sugar intake in South Africa: findings from the Adult Prospective Urban and Rural Epidemiology cohort study. The American journal of clinical nutrition, 99(6), 1479-1486. https://doi.org/10.3945/ajcn.113.069005 [Google Scholar] [Crossref]

41. Weiser, S. D., Young, S. L., Cohen, C. R., Kushel, M. B., Tsai, A. C., Tien, P. C., ... & Bangsberg, D. R. (2011). Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. The American journal of clinical nutrition, 94(6), 1729S-1739S. [Google Scholar] [Crossref]

42. World Health Organization. (2018). Noncommunicable diseases: Key facts. WHO. [Google Scholar] [Crossref]

43. World Health Organization. (2023). Hypertension and diabetes management guidelines. WHO. [Google Scholar] [Crossref]

44. Yamane, T. (1967). Statistics: An introductory analysis (2nd ed.). Harper and Row. [Google Scholar] [Crossref]

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