Health policy brief: Towards prevention of risk factors for non-communicable diseases among people living with HIV infection in Rwanda

Abstract

People living with the HIV infection (PLWHI) can now live longer due to the availability and effective use of combination antiretroviral therapy (cART). Eastern and Southern Africa remains the region affected by HIV. Rwanda is one the Eastern Africa that has achieved high rates of antiretroviral therapy (ART) coverage, accounting 164,262 (78%) of all PLWHI in 2016. However, both HIV infection and continued use of life-long cART medications have been associated with a constellation of non-communicable diseases (NCDs). Additionally, HIVinfected (HIV+) persons are at increased risk of NCDs, especially cardiometabolic diseases (CMD), compared to HIV-uninfected (HIV-) counterparts. People living with HIV infection are at an increased risk for NCDs due to their HIV status and their resultant reduced immunity, the use of some cART, and contextual and sociodemographic factors. Fortunately, lifestyle factors including regular physical activity participation, diet modification, and smoking cessation could play a major role in preventing CMD, and in improving life expectancy for HIV+ individuals. However, these interventions are not always integrated in routine African clinical settings, particularly in Rwanda. Currently, health-related benefits of people living with HIV infection on established ART, has shifted from survival to a health-related quality of life outcome (HRQOL).