{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:55:33Z","timestamp":1788173733791,"version":"build-2803163510"},"reference-count":84,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite growing evidence on the rising burden of non\u2010communicable diseases (NCDs) in sub\u2010Saharan Africa, the national prevalence of hypertension, prediabetes and diabetes among persons living with HIV (PLHIV) in Zambia is largely unknown. This study aimed to determine the national prevalence of hypertension and diabetes mellitus and their associated risk factors among adult PLHIV in Zambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional study in 149 antiretroviral therapy (ART) clinics located in 52 rural and urban districts in Zambia based on the adapted World Health Organization (WHO) STEPwise approach to NCD risk factor Surveillance (STEPS) and the Zambia Population\u2010Based HIV Impact Assessment (ZAMPHIA) questionnaire. We used proportional to size sampling to select districts and clinics, targeting 5775 PLHIV. Data was collected from 1 October 2023 to 30 November 2023. We estimated the prevalence of hypertension and diabetes mellitus and used robust Poisson regression to analyse associations with socio\u2010demographic, behavioural and HIV\u2010related risk factors, and reported prevalence ratios (PR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the final analysis, we included a total of 5204 participants from 52 districts and 149 ART clinics countrywide: 67.2% were female, and 71.3% were from urban areas. The prevalence of hypertension, prediabetes and diabetes was 22.5% (95% confidence interval [CI]: 21.3\u221223.6), 26.7% (CI: 25.5\u221227.9) and 12.5% (CI: 11.6\u221213.4), respectively. In the multivariable model, being 30\u201344 (PR = 2.1; CI: 1.5\u22122.9), 45\u201349 (PR = 3.3; CI: 2.4\u22124.7) and 60 years or older (PR = 4.7; CI: 3.3\u22126.8) compared to those aged 18\u201329; widowed, divorced or separated individuals compared to those never married; being overweight (PR = 1.4; CI: 1.2\u22121.5) and obese (PR = 1.9; CI: 1.6\u22122.1) compared to normal weight PLHIV was associated with hypertension. College or university\u2010educated PLHIV (PR = 2.1; CI: 1.3\u22123.4), compared to those with no formal education; and those with high total cholesterol \u22656.2 mmol\/l (PR = 2.2; CI: 1.4\u22123.6), versus desirable total cholesterol (&lt;5.2 mmol\/l); being overweight (PR = 1.4; CI: 1.1\u22121.6) and obese (PR = 1.6; CI: 1.3\u22122.0), compared to those with normal weight, showed a significant association with diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of hypertension and diabetes mellitus among PLHIV in Zambia was notably high. This underscores the need for immediate and robust intervention strategies to mitigate the high prevalence of hypertension and diabetes mellitus, along with their associated risk factors, particularly within this vulnerable demographic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70051","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T10:21:04Z","timestamp":1759832464000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence and risk factors of hypertension and diabetes among persons living with HIV in Zambia: results of a national facility\u2010based cross\u2010sectional survey"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-1599","authenticated-orcid":false,"given":"Chomba","family":"Mandyata","sequence":"first","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"},{"name":"Center for Infectious Disease Research in Zambia (CIDRZ)  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivile","family":"Suilanji","sequence":"additional","affiliation":[{"name":"Ministry of Health  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Bosomprah","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Research in Zambia (CIDRZ)  Lusaka Zambia"},{"name":"Department of Biostatistics School of Public Health University of Ghana  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Somwe","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Research in Zambia (CIDRZ)  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmas","family":"Zyambo","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwiche","family":"Musukuma","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aggrey","family":"Mweemba","sequence":"additional","affiliation":[{"name":"Ministry of Health  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malizgani Paul","family":"Chavula","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chipefwe","family":"Sichilima","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebe","family":"Bwembya","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpanji","family":"Siwingwa","sequence":"additional","affiliation":[{"name":"Ministry of Health  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Chibale","sequence":"additional","affiliation":[{"name":"Ministry of Health  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Phiri","sequence":"additional","affiliation":[{"name":"Ministry of Health  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Zulu","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halwindi","family":"Hikabasa","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbroad","family":"Mutale","sequence":"additional","affiliation":[{"name":"School of Public Health University of Zambia  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(22)00366-6"},{"key":"e_1_2_11_3_1","volume-title":"Zambia Population\u2010based HIV Impact Assessment (ZAMPHIA 2021)","author":"Ministry of Health\u2010Zambia","year":"2023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000298"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001014"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.189624"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis195"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000257"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001718"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12421"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195443"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1335-9"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8378947"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.58.8.721"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.5.725"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000210"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6916497"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10318-6"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6405-9-31"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70002-6"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1304127"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-018-0728-6"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2013.11.017"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290450033020"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.16.2.434"},{"key":"e_1_2_11_26_1","first-page":"E93","article-title":"Integration of HIV and noncommunicable diseases in health care delivery in low\u2010 and middle\u2010income countries","volume":"9","author":"Nigatu T","year":"2012","journal-title":"Prev Chronic Dis"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-2013"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.4.683"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.09.032"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215620"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-018-0927-y"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101836"},{"issue":"1","key":"e_1_2_11_33_1","first-page":"203","article-title":"Overweight and obesity among people living with HIV on dolutegravir\u2010 and efavirenz\u2010based therapies: a comparative cross\u2010sectional study","volume":"2024","author":"Jemal M","year":"2024","journal-title":"AIDS Res Treat"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13761"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00143-7"},{"key":"e_1_2_11_36_1","volume-title":"Global report on hypertension: the race against a serial killer","author":"WHO","year":"2023"},{"key":"e_1_2_11_37_1","unstructured":"WHO\u2010PAHO.Economics of NCDs [Internet].2024[cited 2024 July 20]. Available from:https:\/\/www.paho.org\/en\/topics\/economics\u2010ncds"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.4111"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26059"},{"key":"e_1_2_11_40_1","volume-title":"Zambia STEPS Noncommunicable Disease Risk Factors Survey","author":"WHO and MoH, Zambia","year":"2017"},{"key":"e_1_2_11_41_1","unstructured":"WHO.Standard STEPS instrument [Internet].2020[cited 2022 Feb 5]. Available from:https:\/\/www.who.int\/publications\/m\/item\/standard\u2010steps\u2010instrument"},{"key":"e_1_2_11_42_1","volume-title":"Guideline for the pharmacological treatment of hypertension in adults [Internet]","author":"WHO","year":"2021"},{"key":"e_1_2_11_43_1","volume-title":"WHO technical specifications for automated non\u2010invasive blood pressure measurement devices with cuff","author":"WHO","year":"2020"},{"key":"e_1_2_11_44_1","volume-title":"Guidance on regulations for the transport of infectious substances 2021\u20132022 [Internet]","author":"WHO","year":"2021"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2017.00193"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2014.149"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2016.08.012"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04394"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-023-08679-x"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253742"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09829-5"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-24997-7"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.2174\/157016211796320360"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2021.38.216.28034"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001686"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102255"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14091-y"},{"issue":"4","key":"e_1_2_11_58_1","article-title":"Prevalence, awareness, treatment, control of hypertension, and availability of hypertension services for patients living with human immunodeficiency virus (HIV) in sub\u2010Saharan Africa (SSA): a systematic review and meta\u2010analysis","volume":"15","author":"Isaac Derick K","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_59_1","volume-title":"WHO package of essential noncommunicable disease intervention for primary health care","author":"WHO","year":"2020"},{"key":"e_1_2_11_60_1","unstructured":"WHO.HEARTS: Technical package for cardiovascular disease management in primary health care: risk\u2010based CVD management [Internet].2020. Accessed 2 Jan 2025.https:\/\/www.who.int\/publications\/i\/item\/9789240001367"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-018-0812-z"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60283-9"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200994"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3916-x"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v12i1.2473"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2019.1695727"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2022.05.035"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230723"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-063318"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-19351-7"},{"key":"e_1_2_11_71_1","volume-title":"Metabolic syndrome\u2014lifestyle and biological risk factors [Internet]","year":"2024"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30181-4"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001700"},{"key":"e_1_2_11_74_1","unstructured":"WHO.HEARTS\u2014D: Diagnosis and Management of Type 2 Diabetes [Internet].2020[cited 2023 Dec 6]. Available from:https:\/\/iris.who.int\/bitstream\/handle\/10665\/331710\/WHO\u2010UCN\u2010NCD\u201020.1\u2010eng.pdf?sequence=1"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-564"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2017.75"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.00920"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1080\/14779072.2021.1855975"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-024-00601-z"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01573-8"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3221-7"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0177"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2017.12.014"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/5998727"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05512-7"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T06:35:51Z","timestamp":1764484551000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.70051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":84,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/jia2.70051"],"URL":"https:\/\/doi.org\/10.1002\/jia2.70051","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-01-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70051"}}