Abstract / Summary
s Background With aging demographic, people living with HIV (PLHIV) are increasingly experiencing non-communicable diseases (NCDs) such as diabetes mellitus (DM), Hypertension (HTN), heart disease, stroke, cancer, and respiratory disease, alongside challenges in NCD care-seeking. Objectives To estimate the burden, identify risk factors of NCDs among PLHIV and explore NCD-care seeking behaviors, barriers, feasibility and challenges to implementing integrated HIV-NCD care. Methods Convergent parallel mixed-methods research with quantitative cross-sectional strand among 279 systematically selected adult PLHIV at an antiretroviral therapy (ART) center, captured NCD burden and healthcare seeking behavior. In-depth interviews (IDIs) of 10 purposively selected PLHIV and three key-informant interviews (KIIs) of conveniently selected ART service providers, in qualitative strand explored care-seeking patterns, barriers, feasibility and challenges to implementing integrated care. Results More than a quarter (29.8%) reported NCDs, predominantly DM (14.0%) and HTN (13.3%). Older age, physical inactivity, and obesity were significant risk factors. The private health sector was the preferred source for NCD-care (59%), with increasing preference among PLHIV suffering from NCD multimorbidity (66.7%). Qualitative exploration revealed individual, interpersonal, community and organizational level barriers to NCD care-seeking. Although there was a strong desire for integrated HIV-NCD services, limited resources, insufficient relevant skills, and manpower constraints were among the identified challenges to implementing integrated care within the public system Conclusions Aging PLHIV are experiencing substantial burden of NCDs alongside compounding barriers to seeking healthcare, including fragmented healthcare systems, financial constraints, and physical inabilities. These findings call for integrated HIV-NCD care and warrant further investigation into effective implementation models.