Prevalence And Associated Factors Of Overweight/Obesity And Central Obesity Among Adults Receiving Dolutegravir-Based First-Line Treatment In Health Facilities At Hawassa City Administration, Sidama Region

Background Overweight and obesity are emerging public health challenges globally, increasingly affecting people living with human immunodeficiency virus (HIV). This study assessed the prevalence and factors associated with overweight/obesity and central obesity among adults receiving dolutegravir (DTG)-based first-line antiretroviral therapy (ART) in Hawassa City Administration, Sidama region. Methods This facility-based cross-sectional study was conducted between January 2023 and May 2024 among 439 adults with HIV, selected using systematic sampling. Data were collected using a pretested questionnaire. Anthropometric measurements (weight, height, and waist circumference) were obtained following World Health Organization protocols. Binary logistic regression was used to identify factors associated with overweight/obesity and central obesity. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were used to measure the strength of associations, and statistical significance was set at p < 0.05. Results Among the 433 participants (98.6% response rate), 58.7% were women and the mean age was 40.8 ± 9.6 years. The combined prevalence of overweight/obesity was 45.0% (95% CI: 40.6–49.9), with 31.4% overweight and 13.6% obesity. Central obesity was present in 49.7% (95% CI: 45.3–54.5). Being female (adjusted odds ratio (aOR) = 1.9; 95% CI: 1.3–3.0)), physical inactivity (aOR = 2.9; 95% CI: 1.9–4.6), self-reported recall problem (aOR = 1.6; 95% CI: 1.05–2.4), vegetables consumption ≥5 days/week (aOR = 0.55; 95% CI: 0.32–0.95) and age >40 years (aOR = 1.8; 95% CI: 1.2–2.7) were significantly associated with overweight/obesity. Being female (aOR = 4.9; 95% CI: 2.9–8.3), age >40 years (aOR = 2.7; 95% CI: 1.7–4.3), physical inactivity (aOR = 2.8; 95% CI: 1.7–4.5), self-reported recall problem (aOR = 1.7; 95% CI: 1.04–2.7) and tuberculosis infection (aOR = 0.48; 95%CI: 0.27–0.84) were associated with central obesity. However, switching to DTG, ART duration and duration on DTG were not significantly associated with overweight/obesity or central obesity. Conclusion This study found a substantial burden of overweight/obesity and central obesity among adults receiving DTG-based ART. These findings highlight the importance of incorporating routine anthropometric assessment, nutritional counseling, physical activity promotion, and weight-management support into comprehensive HIV care to reduce this burden.