PMID- 28696346
DCOM- 20170807
LR  - 20180223
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Linking)
VI  - 75
IP  - 5
DP  - 2017 Aug 15
TI  - The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural
      South Africa.
PG  - 561-567
LID - 10.1097/QAI.0000000000001445 [doi]
AB  - BACKGROUND: The prevalence of diabetes and hypertension has increased in
      HIV-positive populations, but there is limited understanding of the role that
      antiretroviral therapy (ART) programs play in the delivery of services for these 
      conditions. The aim of this study is to assess the relationship between ART use
      and utilization of health care services for diabetes and hypertension. METHODS:
      Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South
      Africa is a cohort of 5059 adults. The baseline study collects biomarker-based
      data on HIV, ART, diabetes, and hypertension and self-reported data on health
      care utilization. We calculated differences in care utilization for diabetes and 
      hypertension by HIV and ART status and used multivariable logistic regressions to
      estimate the relationship between ART use and utilization of services for these
      conditions, controlling for age, sex, body mass index, education, and household
      wealth quintile. RESULTS: Mean age, body mass index, hypertension, and diabetes
      prevalence were lower in the HIV-positive population (all P < 0.001).
      Multivariable logistic regression showed that ART use was significantly
      associated with greater odds of blood pressure measurement [adjusted odds ratio
      (aOR) 1.27, 95% confidence interval (CI): 1.04 to 1.55] and blood sugar
      measurement (aOR 1.26, 95% CI: 1.05 to 1.51), counseling regarding exercise (aOR 
      1.57, 95% CI: 1.11 to 2.22), awareness of hypertension diagnosis (aOR 1.52, 95%
      CI: 1.12 to 2.05), and treatment for hypertension (aOR 1.63, 95% CI: 1.21 to
      2.19). CONCLUSIONS: HIV-positive patients who use ART are more likely to have
      received health care services for diabetes and hypertension. This apparent ART
      advantage suggests that ART programs may be a vehicle for strengthening health
      systems for chronic care.
FAU - Manne-Goehler, Jennifer
AU  - Manne-Goehler J
AD  - *Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical
      School, Boston, MA;daggerDepartment of Global Health and Population, Harvard T.H.
      Chan School of Public Health, Boston, MA;double daggerHarvard Center for
      Population and Development Studies, Harvard University, Cambridge, MA; section
      signMedical Research Council/Wits Rural Public Health and Health Transitions
      Research Unit, School of Public Health, University of the Witwatersrand,
      Johannesburg, South Africa; ||Africa Health Research Institute (AHRI),
      KwaZulu-Natal, South Africa; paragraph signResearch Department of Infection and
      Population Health, University College London, London, United Kingdom;#INDEPTH
      Network, Accra, Ghana;**Institute of Public Health, University of Heidelberg,
      Heidelberg, Germany;daggerdaggerDepartment of Cardiovascular Medicine, Brigham
      and Women's Hospital, Harvard Medical School, Boston, MA; anddouble daggerdouble 
      daggerCenter for Health Decision Science, Harvard Medical School, Boston, MA.
FAU - Montana, Livia
AU  - Montana L
FAU - Gomez-Olive, Francesc Xavier
AU  - Gomez-Olive FX
FAU - Rohr, Julia
AU  - Rohr J
FAU - Harling, Guy
AU  - Harling G
FAU - Wagner, Ryan G
AU  - Wagner RG
FAU - Wade, Alisha
AU  - Wade A
FAU - Kabudula, Chodziwadziwa W
AU  - Kabudula CW
FAU - Geldsetzer, Pascal
AU  - Geldsetzer P
FAU - Kahn, Kathleen
AU  - Kahn K
FAU - Tollman, Stephen
AU  - Tollman S
FAU - Berkman, Lisa F
AU  - Berkman LF
FAU - Barnighausen, Till W
AU  - Barnighausen TW
FAU - Gaziano, Thomas A
AU  - Gaziano TA
LA  - eng
GR  - Wellcome Trust/United Kingdom
GR  - P01 AG041710/AG/NIA NIH HHS/United States
GR  - P30 AG024409/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (Anti-HIV Agents)
SB  - IM
SB  - X
MH  - Adult
MH  - Anti-HIV Agents/therapeutic use
MH  - Comorbidity
MH  - Diabetes Mellitus/*epidemiology/*therapy
MH  - Female
MH  - HIV Infections/complications/*drug therapy/*epidemiology
MH  - Humans
MH  - Hypertension/*epidemiology/*therapy
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Patient Acceptance of Health Care/*statistics & numerical data
MH  - Population Surveillance
MH  - Prevalence
MH  - Program Evaluation
MH  - Rural Health Services/*utilization
MH  - Rural Population
MH  - South Africa/epidemiology
PMC - PMC5516957
MID - NIHMS868921
EDAT- 2017/07/12 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/07/12 06:00
PHST- 2017/07/12 06:00 [entrez]
PHST- 2017/07/12 06:00 [pubmed]
PHST- 2017/08/08 06:00 [medline]
AID - 10.1097/QAI.0000000000001445 [doi]
AID - 00126334-201708150-00010 [pii]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2017 Aug 15;75(5):561-567. doi: