MOAB0401 | CARDIOMETABOLIC MULTIMORBIDITY AND ASSOCIATED FACTORS AMONG PEOPLE LIVING WITH HIV AND HYPERTENSION IN BOTSWANA

Gaone Edwin Mogaetsho | University of Botswana, Gaborone, Botswana

With improvements in life expectancy due to the widespread uptake of antiretroviral therapy (ART), people living with HIV (PWH) are increasingly at risk of clustering cardiometabolic diseases. This study assessed the prevalence of cardiometabolic multimorbidity and associated factors among PWH and hypertension. Baseline data of 4,655 PWH with hypertension aged 20 to 75 years old from a cluster randomized controlled trial (trial registration: ClinicalTrials.gov NCT05414526) across 14 clinics enrolled from January 2023 to September 2023 were used for this sub-study. Multimorbidity was defined as the coexistence of HIV, hypertension, and at least one other cardiometabolic disease, including diabetes, chronic kidney disease, hypercholesterolemia, peripheral artery disease, coronary artery disease, and heart failure. Socio-demographic, clinical, and lifestyle factors were summarized using descriptive statistics. Generalized estimating equations (GEE) with a Poisson log-link function and an exchangeable correlation structure were employed to estimate the adjusted risk ratios (aRR), quantifying associations between predictors and multimorbidity. The prevalence of multimorbidity was 1065 (22.9%), higher among females 875 (82.2%), p<0.001. After controlling for intra-cluster correlation, confounding, and multicollinearity, risk factors of multimorbidity were male sex (aRR= 0.34, 95%Cl = [0.11 – 1.08], p=0.068, Ref = Female) and having other comorbidities (aRR= 1.45, 95%Cl = [0.95 – 2.21], p=0.088) at 10% significance level. There is a high prevalence of cardiometabolic multimorbidity among people living with HIV in our setting. Males and people with other underlying comorbidities were risk factors of multimorbidity. These findings highlight the need for integrated care approaches that include lifestyle interventions and systematic screening for cardiometabolic multimorbidity in HIV care programs to improve patient outcomes.